Healthy Living

If your child has fever....Information for Parents

2007-01-31T23:59:00.000-05:00

What is fever?

Fever occurs when the body's internal "thermostat" raises the body temperature above its normal level. This thermostat is found in the part of the brain called the hypothalamus.The hypothalamus knows what temperature your body should be (usually around 98.6 degrees Fahrenheit, or about 37 degrees Celsius) and will send messages to your body to keep it that way.

Most people's body temperatures even change a little bit during the course of the day: It's usually a little lower in the morning and a little higher in the evening and can fluctuate as kids run around, play, and exercise.

Sometimes, though, the hypothalamus will "reset" the body to a higher temperature in response to an infection, illness, or some other cause. So, why does the hypothalamus tell the body to change to a new temperature? Researchers believe turning up the heat is the body's way of fighting the germs that cause infections and making the body a less comfortable place for them.

Causes of Fever:

t's important to remember that by itself fever is not an illness - it's usually a symptom of an underlying problem. Fever has several potential causes:

Infection: Most fevers are caused by infection or other illness. Fever helps the body fight infections by stimulating natural defense mechanisms.

Overbundling:Infants, especially newborns, may get fevers if they're overbundled or in a hot environment because they can't regulate their body temperature.

Immunizatio: Babies and children sometimes get a low-grade fever after getting vaccinated.

Although teething may cause a slight rise in body temperature, it's probably not the cause if your baby's or toddler's temperature is higher than 100 degrees Fahrenheit (37.8 degrees Celsius).

Should I call a doc?

In the past, doctors advised treating a fever on the basis of temperature alone. But now, they recommend taking both the temperature and the child's overall condition into account.

Children whose temperatures are lower than 102 degrees Fahrenheit (38.9 degrees Celsius) usually don't require medication, unless they're uncomfortable. There's one important exception to this rule: If you have an infant 3 months or younger with a rectal temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, call your baby's doctor or go to the emergency department. Even a slight fever can be a sign of a potentially serious infection in very young infants.

For older children, take behavior and activity level into account. By watching how your child behaves, you can get a pretty good idea as to whether he or she has a minor illness or needs to be seen by a doctor.

The illness is probably not serious if your child:

is still interested in playing
is eating and drinking well
is alert and smiling at you
has a normal skin color
looks well when his or her temperature comes down

And don't worry too much about a child with a fever who doesn't want to eat. This is very common with infections that cause fever.

How will I know if my child has fever?

A gentle kiss on the forehead or a hand placed lightly on your child's skin is often enough to tell that your child has a fever. However, this method of taking a temperature (called tactile temperature) is dependent on the person doing the feeling and doesn't give an accurate measure of a child's temperature.

By using a reliable thermometer, you can tell if your child has a fever if his or her temperature is at or higher than one of the following levels:

100.4 degrees Fahrenheit (38 degrees Celsius) measured rectally (in the bottom)
99.5 degrees Fahrenheit (37.5 degrees Celsius) measured orally (in the mouth)
99 degrees Fahrenheit (37.2 degrees Celsius) measured in an axillary position (under the arm)

But how high a fever is doesn't tell you much about how sick your child is. A simple cold or other viral infection can sometimes cause a rather high fever (in the 102 to 104 degrees Fahrenheit, or 38.9 to 40 degrees Celsius, range), but doesn't usually indicate a serious problem. And serious infections may cause no fever or even an abnormally low body temperature, especially in young infants.

Because fevers may rise and fall, a child with fever may experience chills, which occur when the body tries to generate additional heat when the body's temperature begins to rise. The child may sweat as the body releases extra heat when the temperature starts to drop.

Sometimes children with a fever may also breathe faster than usual and may have a higher heart rate. You should call your child's doctor if your child is having difficulty breathing, is breathing a lot faster than normal, or continues to breathe fast after the fever comes down.

Please call your doctor if:

The exact temperature that should trigger a call to the doctor depends on the age of the child, the illness, and whether the child has other symptoms with the fever.

Call your child's doctor if you have an:

infant younger than 3 months with a temperature of 100.4 degrees Fahrenheit (38 degrees Celsius)
older child with a temperature of higher than 104 degrees Fahrenheit (40 degrees Celsius)

If an older child has a fever of less than 104 degrees, call the doctor if the child also:

refuses fluids or seems too ill to drink adequately
has persistent diarrhea or repeated vomiting
has any signs of dehydration
has a specific complaint (i.e., sore throat or earache)
still has a fever after 24 hours in a child younger than 2 years or 72 hours in a child 2 years or older
has recurrent fevers, even if they only last a few hours each night

Seek emergency care if your child shows any of the following signs along with a fever:

inconsolable crying for several hours
extreme irritability
lethargy and difficulty waking
rash or purple spots that look like bruises on the skin (that were not there before the child got sick)
blue lips, tongue, and nails
infant's soft spot on the head seems to be bulging outward
stiff neck
severe headache
limpness and refusal to move
difficulty breathing that doesn't get better when the nose is cleared
leaning forward and drooling
seizure

Also, check with your child's doctor for his or her specific guidelines on when to call about a fever.

Irritable Bowel Syndrome...what you MUST know!!!

2007-01-30T19:59:00.000-05:00

What is Irritable Bowel Syndrome:

Irritable bowel syndrome, or IBS, is a problem that affects mainly the bowel which is also called the large intestine. The bowel is the part of the digestive system that makes and stores stool. The word syndrome means a group of symptoms. IBS is a syndrome because it can cause several symptoms. For example, IBS causes cramping, bloating, gas, diarrhea, and constipation.

IBS is not a disease. It's a functional disorder, which means that the bowel doesn't work as it should.

With IBS, the nerves and muscles in the bowel are extra-sensitive. For example, the muscles may contract too much when you eat. These contractions can cause cramping and diarrhea during or shortly after a meal. Or the nerves can be overly sensitive to the stretching of the bowel (because of gas, for example). Cramping or pain can result.IBS can be painful. But it does not damage the bowel or cause any other diseases.

What may cause IBS?

Emotional stress will not cause a person to develop IBS. But if you already have IBS, stress can trigger symptoms. In fact, the bowel can overreact to all sorts of things, including food, exercise, and hormones.

Foods that tend to cause symptoms include milk products, chocolate, alcohol, caffeine, carbonated drinks, and fatty foods. In some cases, simply eating a large meal will trigger symptoms.

Women with IBS often have more symptoms during their menstrual periods.

What are the symptoms of OBS?

he main symptoms of IBS are

crampy pain in the stomach area
painful diarrhea or constipation

Most people have either diarrhea or constipation, but some people have both.

Other symptoms are in the stool

mucus in stools.

swollen or bloated abdomen
the feeling that you have not finished a bowel movement

How is it diagnosed?

The doctor will suspect that you have IBS because of your symptoms. But the doctor may do medical tests to make sure you don't have any other diseases that could cause the symptoms.

What about treatment?

Unfortunately, IBS has no cure, but you can do things to relieve symptoms. Treatment may involve

diet changes
medicine
stress relief

You may have to try a combination of things to see which works best for you.

Diet Changes you can use to avoid IBS:Here are some foods that may cause symptoms:

fatty foods like french fries
milk products like cheese or ice cream
chocolate
alcohol
caffeine (found in coffee and some sodas)
carbonated drinks like soda

What makes IBS symptoms better?

Fiber reduces IBS symptoms—especially constipation—because it makes stool soft, bulky, and easier to pass. Fiber is found in

Bran
Bread (Whole-grain bread)
Cereal (Whole-grain cereal)
Beans (Kidney beans Lima beans)
Fruit (Apples Peaches)
Vegetables (Broccoli, raw cabbage,carrots, raw peas)

Some more advice from the doc!!

Add foods with fiber to your diet a little at a time to let your body get used to them. Too much fiber all at once might cause gas, which can trigger symptoms in a person with IBS.

Besides telling you to eat more foods with fiber, the doctor might also tell you to get more fiber by taking a fiber pill or drinking water mixed with a special high-fiber powder.

Medicines your doc may prescribe:

If necessary, the doctor might give you medicine to help with symptoms:

Laxatives: to treat constipation
Anti Spasmodics: To slow contractions in the bowel, which helps with diarrhea and pain.
Anti Depresants: To help those who have severe pain

You must follow your doctor's instructions when you use these medicines. Otherwise, you could become dependent on them.

But how can I relieve stress?

Does stress trigger your symptoms? Learning to reduce stress can help. With less stress, you may find that you have less cramping and pain. Also, you may find it easier to manage your symptoms.Meditation, exercise, and counseling are some things that might help. You may need to try different activities to see what works best for you.

Ok I got bored and did not read everything you wrote...tell me what I should really remember:

IBS is a functional disorder in which the bowel doesn't work as it should.
IBS can cause cramping, bloating, gas, diarrhea, and constipation.
IBS doesn't damage the bowel.
The doctor will diagnose IBS based on your symptoms. You might have some medical tests to rule out other diseases.
Stress doesn't cause IBS, but it can trigger symptoms.
Fatty foods, milk products, chocolate, caffeine, carbonated drinks, and alcohol can trigger symptoms.
Eating foods with fiber and eating smaller meals can reduce symptoms.
Treatment for IBS may include medicine, stress relief, or changes in eating habits.

Carpal Tunnel Syndrome

2007-01-26T00:22:00.000-05:00

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a painful progressive condition caused by compression of a key nerve in the wrist. It occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist. Symptoms usually start gradually, with pain, weakness, or numbness in the hand and wrist, radiating up the arm. As symptoms worsen, people might feel tingling during the day, and decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In some cases no direct cause of the syndrome can be identified. Most likely the disorder is due to a congenital predisposition - the carpal tunnel is simply smaller in some people than in others. However, the risk of developing carpal tunnel syndrome is especially common in those performing assembly line work.

Is there any treatment?

Initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending. Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and other nonprescription pain relievers, may ease pain. Cool (ice) packs and prednisone (taken by mouth) or lidocaine (injected directly into the wrist) can relieve swelling and pressure on the median nerve and provide immediate, temporary relief.

What is the prognosis?

Recurrence of carpal tunnel syndrome following treatment is rare. The majority of patients recover completely. To prevent workplace-related carpal tunnel syndrome, workers can do on-the-job conditioning, perform stretching exercises, take frequent rest breaks, wear splints to keep wrists straight, and use correct posture and wrist position. Wearing fingerless gloves can help keep hands warm and flexible.

Back Pain...ouch!!!!

2007-01-26T00:20:00.000-05:00

What is Back Pain?

Acute or short-term low back pain generally lasts from a few days to a few weeks. Most acute back pain is the result of trauma to the lower back or a disorder such as arthritis. Pain from trauma may be caused by a sports injury, work around the house or in the garden, or a sudden jolt such as a car accident or other stress on spinal bones and tissues. Symptoms may range from muscle ache to shooting or stabbing pain, limited flexibility and range of motion, or an inability to stand straight. Chronic back pain is pain that persists for more than 3 months. It is often progressive and the cause can be difficult to determine.

Is there any treatment?

Most low back pain can be treated without surgery. Treatment involves using over-the-counter pain relievers to reduce discomfort and anti-inflammatory drugs to reduce inflammation. The goal of treatment is to restore proper function and strength to the back, and prevent recurrence of the injury. Medications are often used to treat acute and chronic low back pain. Effective pain relief may involve a combination of prescription drugs and over-the-counter remedies. Although the use of cold and hot compresses has never been scientifically proven to quickly resolve low back injury, compresses may help reduce pain and inflammation and allow greater mobility for some individuals. Bed rest is recommended for only 1–2 days at most. Individuals should resume activities as soon as possible. Exercise may be the most effective way to speed recovery from low back pain and help strengthen back and abdominal muscles. In the most serious cases, when the condition does not respond to other therapies, surgery may relieve pain caused by back problems or serious musculoskeletal injuries.

What is the prognosis?

Most patients with back pain recover without residual functional loss, but individuals should contact a doctor if there is not a noticeable reduction in pain and inflammation after 72 hours of self-care. Recurring back pain resulting from improper body mechanics or other nontraumatic causes is often preventable. Engaging in exercises that don't jolt or strain the back, maintaining correct posture, and lifting objects properly can help prevent injuries. Many work-related injuries are caused or aggravated by stressors such as heavy lifting, vibration, repetitive motion, and awkward posture. Applying ergonomic principles — designing furniture and tools to protect the body from injury — at home and in the workplace can greatly reduce the risk of back injury and help maintain a healthy back.

Diabetes

2007-01-26T00:08:00.000-05:00

What is Diabetes?

Diabetes is a disorder of metabolism the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body.

After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.

When we eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body in the urine. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

Types of Diabetes:

The three main types of diabetes are

type 1 diabetes
type 2 diabetes
gestational diabetes

Type 1 Diabetes:

Type 1 diabetes is an autoimmune disease. An autoimmune disease results when the body�s system for fighting infection (the immune system) turns against a part of the body. In diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. The pancreas then produces little or no insulin. A person who has type 1 diabetes must take insulin daily to live.

At present, scientists do not know exactly what causes the body�s immune system to attack the beta cells, but they believe that autoimmune, genetic, and environmental factors, possibly viruses, are involved. Type 1 diabetes accounts for about 5 to 10 percent of diagnosed diabetes in the United States. It develops most often in children and young adults but can appear at any age.

Symptoms of type 1 diabetes usually develop over a short period, although beta cell destruction can begin years earlier. Symptoms may include increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme fatigue. If not diagnosed and treated with insulin, a person with type 1 diabetes can lapse into a life-threatening diabetic coma, also known as diabetic ketoacidosis.

Type 2 Diabetes:

The most common form of diabetes is type 2 diabetes. About 90 to 95 percent of people with diabetes have type 2. This form of diabetes is most often associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and certain ethnicities. About 80 percent of people with type 2 diabetes are overweight.

Type 2 diabetes is increasingly being diagnosed in children and adolescents. However, nationally representative data on prevalence of type 2 diabetes in youth are not available.

When type 2 diabetes is diagnosed, the pancreas is usually producing enough insulin, but for unknown reasons the body cannot use the insulin effectively, a condition called insulin resistance. After several years, insulin production decreases. The result is the same as for type 1 diabetes—glucose builds up in the blood and the body cannot make efficient use of its main source of fuel.

The symptoms of type 2 diabetes develop gradually. Their onset is not as sudden as in type 1 diabetes. Symptoms may include fatigue, frequent urination, increased thirst and hunger, weight loss, blurred vision, and slow healing of wounds or sores. Some people have no symptoms.

Gestational Diabetes

Some women develop gestational diabetes late in pregnancy. Although this form of diabetes usually disappears after the birth of the baby, women who have had gestational diabetes have a 20 to 50 percent chance of developing type 2 diabetes within 5 to 10 years. Maintaining a reasonable body weight and being physically active may help prevent development of type 2 diabetes.

About 3 to 8 percent of pregnant women in the United States develop gestational diabetes. As with type 2 diabetes, gestational diabetes occurs more often in some ethnic groups and among women with a family history of diabetes. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Women with gestational diabetes may not experience any symptoms.

How is Diabetes diagnosed?

The fasting blood glucose test is the preferred test for diagnosing diabetes in children and nonpregnant adults. It is most reliable when done in the morning. However, a diagnosis of diabetes can be made based on any of the following test results, confirmed by retesting on a different day:

A blood glucose level of 126 milligrams per deciliter (mg/dL) or more after an 8-hour fast. This test is called the fasting blood glucose test.
A blood glucose level of 200 mg/dL or more 2 hours after drinking a beverage containing 75 grams of glucose dissolved in water. This test is called the oral glucose tolerance test (OGTT).
A random (taken at any time of day) blood glucose level of 200 mg/dL or more, along with the presence of diabetes symptoms.

Gestational diabetes is diagnosed based on blood glucose levels measured during the OGTT. Glucose levels are normally lower during pregnancy, so the cutoff levels for diagnosis of diabetes in pregnancy are lower. Blood glucose levels are measured before a woman drinks a beverage containing glucose. Then levels are checked 1, 2, and 3 hours afterward. If a woman has two blood glucose levels meeting or exceeding any of the following numbers, she has gestational diabetes: a fasting blood glucose level of 95 mg/dL, a 1-hour level of 180 mg/dL, a 2-hour level of 155 mg/dL, or a 3-hour level of 140 mg/dL.

Who gets Diabetes:

Diabetes is not contagious. People cannot “catch” it from each other. However, certain factors can increase the risk of developing diabetes.

Type 1 diabetes occurs equally among males and females but is more common in whites than in non-whites. Data from the World Health Organization's Multinational Project for Childhood Diabetes indicate that type 1 diabetes is rare in most African, American Indian, and Asian populations. However, some northern European countries, including Finland and Sweden, have high rates of type 1 diabetes. The reasons for these differences are unknown. Type 1 diabetes develops most often in children but can occur at any age.

Type 2 diabetes is more common in older people, especially in people who are overweight, and occurs more often in African Americans, American Indians, some Asian Americans, Native Hawaiians and other Pacific Islander Americans, and Hispanics/Latinos. On average, non-Hispanic African Americans are 1.8 times as likely to have diabetes as non-Hispanic whites of the same age. Mexican Americans are 1.7 times as likely to have diabetes as non-Hispanic whites of similar age. (Data are not available for estimation of diabetes rates in other Hispanic/Latino groups.) American Indians have one of the highest rates of diabetes in the world. On average, American Indians and Alaska Natives are 2.2 times as likely to have diabetes as non-Hispanic whites of similar age. Although prevalence data for diabetes among Asian Americans and Pacific Islanders are limited, some groups, such as Native Hawaiians, Asians, and other Pacific Islanders residing in Hawaii (aged 20 or older) are more than twice as likely to have diabetes as white residents of Hawaii of similar age.

Diabetes prevalence in the United States is likely to increase for several reasons. First, a large segment of the population is aging. Also, Hispanics/Latinos and other minority groups at increased risk make up the fastest-growing segment of the U.S. population. Finally, Americans are increasingly overweight and sedentary. According to recent estimates from the Centers for Disease Control and Prevention (CDC), diabetes will affect one in three people born in 2000 in the United States. The CDC also projects the prevalence of diagnosed diabetes in the United States will increase 165 percent by 2050

How is Diabetes managed?

Before the discovery of insulin in 1921, everyone with type 1 diabetes died within a few years after diagnosis. Although insulin is not considered a cure, its discovery was the first major breakthrough in diabetes treatment.

Today, healthy eating, physical activity, and taking insulin are the basic therapies for type 1 diabetes. The amount of insulin must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose checking. People with diabetes also monitor blood glucose levels several times a year with a laboratory test called the A1C. Results of the A1C test reflect average blood glucose over a 2- to 3-month period.

Healthy eating, physical activity, and blood glucose testing are the basic management tools for type 2 diabetes. In addition, many people with type 2 diabetes require oral medication, insulin, or both to control their blood glucose levels.

Adults with diabetes are at high risk for cardiovascular disease (CVD). In fact, at least 65 percent of those with diabetes die from heart disease or stroke. Managing diabetes is more than keeping blood glucose levels under control it is also important to manage blood pressure and cholesterol levels through healthy eating, physical activity, and use of medications (if needed). By doing so, those with diabetes can lower their risk. Aspirin therapy, if recommended by the health care team, and smoking cessation can also help lower risk.

People with diabetes must take responsibility for their day-to-day care. Much of the daily care involves keeping blood glucose levels from going too low or too high. When blood glucose levels drop too low—a condition known as hypoglycemia—a person can become nervous, shaky, and confused. Judgment can be impaired, and if blood glucose falls too low, fainting can occur.

A person can also become ill if blood glucose levels rise too high, a condition known as hyperglycemia.

People with diabetes should see a health care provider who will help them learn to manage their diabetes and who will monitor their diabetes control. Most people with diabetes get care from primary care physicians internists, family practice doctors, or pediatricians. Often, having a team of providers can improve diabetes care. A team can include

a primary care provider such as an internist, a family practice doctor, or a pediatrician
an endocrinologist (a specialist in diabetes care)
a dietitian, a nurse, and other health care providers who are certified diabetes educators—experts in providing information about managing diabetes
a podiatrist (for foot care)
an ophthalmologist or an optometrist (for eye care)

and other health care providers, such as cardiologists and other specialists. In addition, the team for a pregnant woman with type 1, type 2, or gestational diabetes should include an obstetrician who specializes in caring for women with diabetes. The team can also include a pediatrician or a neonatologist with experience taking care of babies born to women with diabetes.

The goal of diabetes management is to keep levels of blood glucose, blood pressure, and cholesterol as close to the normal range as safely possible. A major study, the Diabetes Control and Complications Trial (DCCT), sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), showed that keeping blood glucose levels close to normal reduces the risk of developing major complications of type 1 diabetes.

This 10-year study, completed in 1993, included 1,441 people with type 1 diabetes. The study compared the effect of two treatment approaches intensive management and standard management on the development and progression of eye, kidney, nerve, and cardiovascular complications of diabetes. Intensive treatment aimed to keep A1C levels as close to normal (6 percent) as possible. Researchers found that study participants who maintained lower levels of blood glucose through intensive management had significantly lower rates of these complications. More recently, a follow-up study of DCCT participants showed that the ability of intensive control to lower the complications of diabetes has persisted more than 10 years after the trial ended.

The United Kingdom Prospective Diabetes Study, a European study completed in 1998, showed that intensive control of blood glucose and blood pressure reduced the risk of blindness, kidney disease, stroke, and heart attack in people with type 2 diabetes.

Points to Remember

What is diabetes?

a disorder of metabolism—the way the body uses or converts food for energy and growth

What are the main types of diabetes?

type 1 diabetes
type 2 diabetes
gestational diabetes

What are the impacts of diabetes?

It affects 20.8 million people—7.0 percent of the U.S. population.
It is a leading cause of death and disability.
It costs $132 billion per year.

Who gets diabetes?

people of any age
people with a family history of diabetes
others at high risk for type 2 diabetes: older people, overweight and sedentary people, African Americans, Alaska Natives, American Indians, Asian Americans, Native Hawaiians, some Pacific Islander Americans, and Hispanics/Latinos

ADD...What every parent should know..

2007-01-24T16:59:00.000-05:00

What is ADD?

Attention Deficit Disorder, or ADD/ADHD, is a psychological term currently applied to anyone who meets the DSM IV diagnostic criteria for impulsivity, hyperactivity and/or inattention. The diagnostic criteria are subjective and include behavior which might be caused by a wide variety of factors, ranging from brain defects to allergies to giftedness. ADD, as currently defined, is a highly subjective description, not a specific disease.

Confusion and controversy is caused by the tendency of some mental health professionals to assume that everyone diagnosed with ADD has some mysterious, irreversible brain defect. This assumption has its roots in the very first group of severely ADD people ever studied, who suffered from encephalitis, or a swelling of the brain. We also have learned that birth defects and brain injury from toxic chemicals such as lead often cause ADD. However, over the last several decades the ADD diagnostic criteria have been so broadened as to include many people with no brain defects at all. Experts in the fields of temperament and creativity have objected that perfectly healthy people are being classified as disordered. Huge numbers of these new types of people being added to the diagnostic pot have changed the way ADD is viewed in some circles, including people like Thom Hartmann, who popularized the idea of ADDers being "Hunters in a Farmer's World". On the other hand, many argue that such people aren't ADD in the first place. Both may be correct. This website was started with the first viewpoint in mind (hence the title), but as time passes I find myself more likely to just say that many so-called ADD people are simply not ADD in the classic sense.

Misconceptions about ADD:

Many people assume ADDers cannot pay attention. This is completely false. In fact, ADDers are known to "hyperfocus" on anything which captures their attention, to the point where it is difficult to get their attention. It is true, however, that a higher degree of interest is necessary before the ADDer can pay attention. ADDers do not tune-out or daydream on purpose or to be rude. Some people have likened it to having an on-off switch in the brain. Interest is needed to activate or "turn on" the brain, after which the ADDer can pay attention. If there is no interest, then the brain is "off" and the ADDer is likely to do something to try and get it back on. This can include sensation seeking, daydreaming, or becoming immersed in something the ADDer finds very interesting. It can also include disruptive behavior. This might be nature's way of making sure that some people are always on the lookout for something new and interesting - these are our explorers and discoverers. Ritalin and other stimulants appear to work by artificially stimulating the brain, allowing the ADDer to tolerate a duller setting than they could otherwise function well in (e.g. schools).

Someone can be ADD and not be hyperactive. Some ADDers, especially girls, are quiet daydreamers.

Oppositional behavior is often confused with ADD. ADD in itself does NOT directly cause oppositional behavior. It can, however, indirectly result in anger and oppositional behavior if the ADDer is chronically mistreated, for example, by parents and teachers who continually blame the child for not "performing" like other children. Such children may give up trying to please their parents and instead misbehave out of frustration and anger. Otherwise, ADD kids are often described as enthusiastic and affectionate by understanding parents. In addition, some people reacting to foods may become hostile as well as hyperactive while they are reacting to the food.

You cannot tell if someone is ADD by their response to stimulants. Most people perform better and feel better when given stimulants, including those who are not ADD. That's why so many people drink coffee.

Types of ADD:

There are two major types of ADD at this time (this aspect of ADD keeps evolving): ADD with hyperactivity (the traditional type of ADD) and ADD without hyperactivity ("inattentive" type). Here are the DSM IV diagnostic criteria in a condensed form:

Inattention (must meet six of the following to a degree that is "maladaptive"):

Often fails to give close attention to details or makes mistakes in schoolwork;
difficulty sustaining attention in tasks;
seems not to listen;
fails to follow instructions or finish work;
unorganized;
difficulties with schoolwork or homework;
loses things like school assignments, books, tools, etc.;
easily distracted;
forgetful about daily activities.

ADD with Hyperactivity (must meet six of the following to a degree that is "maladaptive"):

fidgety in a squirmy sense;
doesn't stay seated;
runs or climbs excessively (or feelings of restlessness in older children);
difficulty playing quietly;
often "on the go" or acts if "driven by a motor";
often talks excessively;
blurts out answers to questions;
difficulty waiting in lines or waiting turns;
often interrupts or intrudes on others.

How is ADD diagnosed?

ADD should be diagnosed by a psychologist or psychiatrist who is knowledgeable about ADD as well as giftedness and creativity. Avoid diagnosis by a pediatrician, since pediatricians as a group are far more likely to simply prescribe medications without properly assessing the child. Psychiatrists and neurologists are far more likely to prescribe medications before acquiring a total picture of the patient.

Adults, especially those with the non-hyperactive form of ADD, may have trouble finding a practitioner knowledgeable in ADD, since until recently ADD was considered a childhood condition. Women with ADD are often told they suffer from depression and are prescribed antidepressants which do not work.

Ask the practitioner what his or her ADD assessment entails. A good assessment typically runs several hours and will include tests for IQ and creativity. Avoid anyone who simply asks a few question and then prescribes medication to "see what happens." Most people do better and feel better on stimulants, even those without ADD, so this is a very bad approach for a professional to follow.

How is ADD treated?

Physicians often recommend that ADHD or AD/HD be treated asymptomatically with stimulant medication, special education and counseling. Although these approaches sometimes yield positive benefits, they may mask the problems rather than get to their underlying causes.
In addition, many common drugs for ADD (such as ritalin, methylphenidate, cylert), which have the same Class 2 classification as cocaine and morphine, can have some negative side effects that relate to appetite, sleep and growth. Placing a normal student who has difficulty paying attention in a special class and counseling could undermine rather than boost his self esteem.

A sensible, multi-disciplinary, developmental approach treats underlying causes rather than the symptoms which are secondary.

VISION THERAPY improves visual skills that allow a person to pay attention. These skill areas include visual tracking, fixation, focus change, binocular fusion and visualization. When all of these are well developed, children and adults can sustain attention, read and write without careless errors, give meaning to what they hear and see, and rely less on movement to stay alert.

OCCUPATIONAL THERAPY for children with sensory integration dysfunction enhances their ability to process lower level senses related to alertness, body movement and position, and touch. This allows them to pay more attention to the higher level senses of hearing and vision.

TREATMENT OF ALLERGIES to pollens, molds, dust, foods and/or chemicals by eliminating or neutralizing them has also been shown to alleviate the identical symptoms, and without side effects.

The public needs to understand that some behavioral optometrists, physicians, educators, mental health professionals, occupational therapists, and allergists are all addressing the same symptoms and behaviors. The difference is that medication, special education, and counseling can mask these symptoms and behaviors, while vision therapy, occupational therapy and/or treatment of allergies may alleviate the underlying causes and thus eliminate the symptoms long-term.

When making a choice about treatment for Attention Deficit Disorder (ADD), Attention Deficit Hyperactivity Disorder (ADHD, AD/HD) or Attention-Deficit Hyperactivity Disorder (ADHD, AD/HD):

Consult a behavioral optometrist for a developmental vision evaluation

Have a child evaluated by an occupational therapist with expertise in sensory processing problems.

Consult an allergist regarding possible reactions to foods or airborne particles.

Peanut Allergy

2007-01-24T16:53:00.000-05:00

What are Nut and Peanut Allergies?

The most common allergy-causing foods are peanuts, tree nuts,milk, eggs, fish, shellfish, wheat, and soy, according to the Food Allergy and Anaphylaxis Network (FAAN). About 1.5 million people in the United States are allergic to peanuts (which are not a true nut, but a legume - in the same family as peas and lentils). Half of those allergic to peanuts are also allergic to tree nuts, such as almonds, walnuts, pecans, cashews, and often sunflower and sesame seeds. The American Academy of Allergy, Asthma, and Immunology estimates that up to 2 million, or 8%, of children in the United States are affected by food allergies and that six foods account for 90% of those food allergy reactions in kids: milk, eggs, peanuts, wheat, soy, and tree nuts.

Food allergies occur when a person's immune system mistakenly believes that something he or she ate is harmful to the body. In an attempt to protect the body, the immune system produces antibodies called immunoglobulin E (IgE). Those antibodies then cause mast cells (which are allergy cells in the body) to release chemicals into the bloodstream, one of which is histamine. The histamine then acts on a person's eyes, nose, throat, lungs, skin, or gastrointestinal tract and causes the symptoms of the allergic reaction. Future exposure to that same allergen (things like nuts or pollen that you can be allergic to are known as allergens) will trigger this antibody response again. This means that every time that person eats that particular food, he or she will have an allergic reaction.

Unlike allergies to other foods like milk and eggs, children generally don't outgrow allergies to peanuts or nuts. But over time, they should become experienced at avoiding the foods that make them ill.

Signs and Symptoms

The first signs of an allergic reaction can be a runny nose, a skin rash all over the body, or a tingly tongue. The symptoms can quickly become more serious - including signs of anaphylaxis (a sudden, potentially severe allergic reaction involving various systems in the body), such as difficulty breathing, swelling of the throat or other parts of the body, a rapid drop in blood pressure, and dizziness or unconsciousness. Other possible symptoms include hives, tightness of the throat, a hoarse voice, nausea, vomiting, abdominal pain, diarrhea, and lightheadedness.

To someone who has no allergies, seeing someone else experiencing anaphylaxis can be just as scary as it is for the allergic person. Anaphylaxis can happen just seconds after being exposed to a triggering substance. It can involve various areas of the body (such as the skin, respiratory tract, gastrointestinal tract, and cardiovascular system), and can be mild to fatal. The annual incidence of anaphylactic reactions is small - about 30 per 100,000 people - although people with asthma,eczema and hay fever are at higher risk.

How is this allergy diagnosed?

Obviously, babies can't tell their parents when their tummies hurt or their throats itch, so diagnosing food allergies early in a child's life can be difficult. Doctors therefore generally recommend that parents refrain from giving their children peanut butter or other peanut or nut products until after they're 2 years old. If there's a family history of food allergies, parents should wait until the child is 3. And many doctors recommend that their pregnant patients - especially those with food allergies - keep the lid on the peanut butter jar until after the baby's born and they're done nursing.

If your doctor suspects your child might have a peanut or nut allergy, he or she will probably refer you to an allergist or allergy specialist for further testing. The allergy specialist will ask you and your child questions, such as how often does your child have the reaction, how quickly do symptoms start after eating a particular food, and whether any family members have allergies or conditions like eczema and asthma.

Allergies are diagnosed using a skin test or blood test, depending on the age and condition of the patient. Initially, the suspected allergen is placed on the skin and the skin is pricked with a plastic toothpick-like instrument. If the child is allergic, a reaction (a welt that looks like a mosquito bite) will develop in 20 minutes. Skin testing can also be done by injecting the suspected allergen under the skin with a needle.

It's important that your child stop taking antiallergy medications (such as over-the-counter antihistamines) 2 to 3 days before a skin test because they can interfere with the results. Most cold medications, as well as some antidepressants, can also affect skin testing. Check with the allergist's office if you're unsure about what medications need to be stopped and for how long.

Some doctors may also take a blood test that will check for antibodies for specific allergens.

If the results of the skin or blood tests are still unclear, then in select cases, a food challenge may be needed for final diagnosis. During this test, your child might be given gradually increasing amounts of nuts or peanuts to eat, while being watched for symptoms by the doctor. This can only be performed in a clinic or hospital where access to immediate medical care and medications is available. And it should be avoided if your child has experienced a clear-cut anaphylactic reaction to nuts or peanuts in the past.

What is the treatment?

There is no real cure for food allergies. The only real way to cope with them on a daily basis is to know the trigger foods and avoid them. So parents must educate their children early and often, not only about the allergy itself but also what reaction they will have if they eat the offending food. The task at hand is to stay vigilant about reading each and every food label and educating others, including relatives, caregivers, neighbors, and teachers.

In case of an emergency, doctors recommend that nut- and peanut-allergic adults and children 12 or 13 and older (depending on the maturity of the child) keep a shot of epinephrine with them in an easy-to-carry container that looks like a pen. Millions of parents across the country carry epinephrine everywhere they go.

With one injection into the thigh, epinephrine, or adrenaline, is administered to ease the allergic reaction. A prescription for epinephrine includes two auto-injections. Your child's doctor can give you instructions on how to use and store the epinephrine injection pen; it's essential that you familiarize yourself with the procedure.

If your child is 12 or older, make sure he or she keeps the pen readily available at all times. If the child is younger than 12, talk to the school nurse, your child's teacher, and your child's child-care provider about keeping one on hand in case of an emergency. Also make sure that epinephrine pens are available at your home, as well as at the homes of friends and family members. Your child's doctor may also encourage your child to wear a medical alert bracelet. It's also a good idea to carry an over-the-counter antihistamine, which can help alleviate allergy symptoms in some people. But antihistamines should not be used as a replacement for the epinephrine.

Kids who have had to take an epinephrine shot should go immediately to a medical facility or hospital emergency department, where additional treatment can be given if needed. Up to one third of anaphylactic reactions can have a second wave of symptoms several hours following the initial attack, so the child might need to be observed in a clinic or hospital for 4 to 8 hours following the reaction.

Caring for your child:

It's important to be vigilant about your child's food allergies, even during simple, everyday activities. Here are some basic tips:

Read food labels. Beginning in 2006, food makers are required to clearly state whether a product contains peanuts or tree nuts that could trigger an allergic reaction. The statement should be in or adjacent to the list of ingredients. (Keep in mind though, this rule only applies to foods labeled after the start of 2006. So some of the products that were made before then and are still on the shelves may not say anything about allergens.)
Avoid cooked foods you didn't make yourself - anything with an unknown list of ingredients. Stay away from baking mixes, chilis, Asian dishes, and buffet restaurants where spoons go in and out of various bowls that may contain nuts or seeds.
Avoid fried foods (especially in restaurants and fast-food places) that may be made with peanut oil or may contain hidden peanuts or nuts.
Don't be cavalier about food allergies - tell everyone who handles the food your child eats, from waiters and waitresses to chefs and bakers. If the manager or owner of a restaurant is uncomfortable about your request for peanut- or nut-free food preparation, don't eat there.
Encourage people not to feed your child. Make your own school lunches, as well as snacks and treats to take to parties, play dates, sleepovers, school functions, and other outings.
Talk to the daycare supervisor or school principal before your child attends. Then talk to your child's classmates or send home a note explaining that your child has a severe allergy to peanuts or nuts. Ask parents to refrain from sending in snacks that have peanuts.
Keep epinephrine accessible at all times - not in the glove compartment of your car, but with you, because seconds count during an anaphylaxis episode. It's a good idea to also keep epinephrine in your child's classroom (not just in the nurse's office), or with your child, depending on state laws.
See a board-certified allergist or your child's doctor regularly.

Here are some other tips that might make life a little easier for you and your nut- or peanut-allergic child:

Use - and encourage others to use - an antiseptic hand wash after meals.
Consult with a dietitian to come up with safe but delicious meals and snacks.
Carry a list of foods to watch out for in your backpack or bag.
Talk to your child's teachers, relatives, caregivers, and close friends about the allergy. Teach them to recognize the signs of anaphylaxis and show them how to help your child.

Quitting Smoking

2007-01-23T21:31:00.000-05:00

The US Surgeon General has stated, "Smoking cessation (stopping smoking) represents the single most important step that smokers can take to enhance the length and quality of their lives."

Quitting smoking is not easy, but it can be done. To have the best chance of quitting successfully, you need to know what you’re up against, what your options are, and where to go for help. This document will provide you with this information.

Why is so hard to quit?

Mark Twain said, "Quitting smoking is easy. I've done it a thousand times." Maybe you've tried to quit too. Why is quitting and staying quit hard for so many people? The answer is nicotine.

What is Nicotine?

Nicotine is a drug found naturally in tobacco. It is highly addictive – as addictive as heroin or cocaine. Over time, the body becomes both physically and psychologically dependent on nicotine. Studies have shown that smokers must overcome both of these addictions to be successful at quitting and staying quit.

When smoke is inhaled, nicotine is carried deep into the lungs, where it is absorbed quickly into the bloodstream and carried throughout the body. Nicotine affects many parts of the body, including your heart and blood vessels, your hormonal system, your metabolism, and your brain. Nicotine can be found in breast milk and even in cervix mucous secretions of smokers. During pregnancy, nicotine freely crosses the placenta and has been found in amniotic fluid and the umbilical cord blood of newborn infants.

Several different factors can affect the rate of metabolism (the work of the living cell in the body) and excretion (or getting rid of the waste) related to nicotine. In general, a regular smoker will have nicotine or its by-products present in the body for about 3 to 4 days after stopping.

Nicotine produces pleasant feelings that make the smoker want to smoke more. It also acts as a kind of depressant by interfering with the flow of information between nerve cells. As the nervous system adapts to nicotine, smokers tend to increase the number of cigarettes they smoke, and therefore the amount of nicotine in their blood. After a while, the smoker develops a tolerance to the drug, which leads to an increase in smoking over time. Over time, the smoker reaches a certain nicotine level and then smokes to maintain this level of nicotine. In fact, nicotine, when inhaled in cigarette smoke, reaches the brain faster than drugs that enter the body intravenously.

Withdrawal pangs:

When smokers try to cut back or quit, the absence of nicotine leads to withdrawal symptoms. Withdrawal is both physical and mental. Physically, the body reacts to the absence of nicotine. Psychologically, the smoker is faced with giving up a habit, which requires a major change in behavior. Both must be addressed in order for the quitting process to work.

Withdrawal symptoms can include any of the following:

dizziness (which may only last 1-2 days in the beginning)
depression
feelings of frustration and anger
irritability
sleep disturbances, including having trouble falling asleep, staying asleep and having bad dreams or even nightmares
trouble concentrating
restlessness
headache
tiredness
increased appetite

These symptoms can lead the smoker to again start smoking cigarettes again to boost blood levels of nicotine back to a level where there are no symptoms.

If a person has smoked regularly for a few weeks or longer and abruptly stops using tobacco or greatly reduces the amount smoked, withdrawal symptoms will occur. Symptoms usually start within a few hours of the last cigarette and peak about 2 to 3 days later. Withdrawal symptoms can last for a few days to several weeks

Health Benefits of quitting:

Health concerns usually top the list of reasons people give for quitting smoking. About half of all smokers who continue to smoke will end up dying from a smoking-related illness. Nearly everyone knows that smoking can cause lung cancer, but few people realize it is also a risk factor for many other kinds of cancer as well, including cancer of the mouth, voice box (larynx), throat (pharynx), esophagus, bladder, kidney, pancreas, cervix, stomach, and some leukemias. For the first time, the Surgeon General includes pneumonia in the list of diseases caused by smoking.

Smoking increases the risk of lung diseases such as emphysema and chronic bronchitis. These progressive lung diseases – grouped under the term COPD (chronic obstructive pulmonary disease) – are usually diagnosed in current or former smokers in their 60s and 70s. COPD causes chronic illness and disability and is eventually fatal.

Smokers are twice as likely to die from heart attacks as are nonsmokers. And smoking is a major risk factor for peripheral vascular disease, a narrowing of the blood vessels that carry blood to the leg and arm muscles, as well as cerebrovascular disease that can cause strokes.

Smoking also causes premature wrinkling of the skin, bad breath, bad smelling clothes and hair, and yellow fingernails and hair, yellow fingernails and an increased risk of macular degeneration, one of the most common causes of blindness in the elderly.

For women, there are unique risks. Women over 35 who smoke and use birth control pills are in a high-risk group for heart attack, stroke, and blood clots of the legs. Women who smoke are more likely to have a miscarriage or a lower birth-weight baby. Low birth-weight babies are more likely to die or to be impaired.

Based on data collected in the late 1990s, the US Centers for Disease Control (CDC) estimated that adult male smokers lost an average of 13.2 years of life and female smokers lost 14.5 years of life because of smoking.

No matter what your age or how long you've smoked, quitting will help you live longer. People who stop smoking before age 50 cut their risk of dying in the next 15 years in half compared with those who continue to smoke. Ex-smokers also enjoy a higher quality of life with fewer illnesses from cold and flu viruses, better self-reported health, and reduced rates of bronchitis and pneumonia.

Ex-smokers also enjoy a higher quality of life with fewer illnesses from cold and flu viruses, better self-reported health status, and reduced rates of bronchitis and pneumonia.

For decades the Surgeon General has reported the health risks associated with smoking. Regardless of your age or smoking history, there are advantages to quitting smoking. Benefits apply whether you are healthy or you already have smoking-related diseases. In 1990, the Surgeon General concluded:

Quitting smoking has major and immediate health benefits for men and women of all ages. Benefits apply to people with and without smoking-related disease.
Former smokers live longer than continuing smokers.
Quitting smoking decreases the risk of lung cancer, other cancers, heart attack, stroke, and chronic lung disease.
Women who stop smoking before pregnancy or during the first 3 to 4 months of pregnancy reduce their risk of having a low birth weight baby to that of women who never smoked.
The health benefits of quitting smoking far exceed any risks from the less than 10 pound weight gain or any adverse psychological effects that may follow quitting.

When Smokers Quit – What Are the Benefits Over Time?

20 minutes after quitting: Your heart rate and blood pressure drops.

12 hours after quitting: The carbon monoxide level in your blood drops to normal.

2 weeks to 3 months after quitting: Your circulation improves and your lung function increases.

1 to 9 months after quitting: Coughing and shortness of breath decrease; cilia (tiny hair-like structures that move mucus out of the lungs) regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection.

1 year after quitting: The excess risk of coronary heart disease is half that of a smoker's.

5 years after quitting: Your stroke risk is reduced to that of a nonsmoker 5 to 15 years after quitting.

10 years after quitting: The lung cancer death rate is about half that of a continuing smoker's. The risk of cancer of the mouth, throat, esophagus, bladder, cervix, and pancreas decrease.

15 years after quitting: The risk of coronary heart disease is that of a nonsmoker's.

Visible and Immediate Rewards of Quitting

Quitting helps stop the damaging effects of tobacco on your appearance including:

Premature wrinkling of the skin
Bad breath
Stained teeth
Gum disease
Bad smelling clothes and hair
Yellow fingernails

Kicking the tobacco habit offers benefits that you'll notice immediately and some that will develop gradually over time. These rewards can improve your day-to-day life immensely.

Food tastes better.
Your sense of smell returns to normal
Ordinary activities no longer leave you out of breath (for example, climbing stairs or light housework)

The prospect of better health is a major reason for quitting, but there are others as well.

Cost: How much will I save if I quit?

Smoking is expensive. It isn't hard to figure out how much you spend on smoking: multiply how much money you spend on tobacco every day by 365 (days per year). The amount may surprise you. Now multiply that by the number of years you have been using tobacco and that amount will probably astound you.

Multiply the cost per year by 10 (for the upcoming 10 years) and ask yourself what you would rather do with that much money.

And this doesn’t include other possible expenses, such as higher costs for health and life insurance, as well as the health care costs due to tobacco-related conditions.

Social Acceptance:

Smoking is less socially acceptable now than it was in the past.

Most workplaces have some type of smoking restrictions. Some employers even prefer to hire nonsmokers. Studies show smoking employees cost businesses more to employ because they are "out sick" more frequently. Employees who are ill more often than others can raise an employer’s need for expensive temporary replacement workers. They can increase insurance costs both for other employees and for the employer, who typically pays part of the workers’ insurance premiums. Smokers in a building also typically increase the maintenance costs of keeping odors at an acceptable level, since residue from cigarette smoke clings to carpets, drapes, and other fabrics.

Landlords may choose not to rent to smokers since maintenance costs and insurance rates may rise when smokers occupy buildings.

Friends may ask you not to smoke in their houses or cars. Public buildings, concerts, and even sporting events are largely smoke-free. And more and more communities are restricting smoking in all public places, including restaurants and bars. Like it or not, finding a place to smoke can be a hassle.

Smokers may find their opportunities for dating or romantic involvement, including marriage, are largely limited to other smokers, who make up only about 1/4th of the population.

Health of Others

Smoking not only harms your health but the health of those around you. Exposure to secondhand smoke (also called environmental tobacco smoke or passive smoking) includes exhaled smoke as well as smoke from burning cigarettes.

Studies have shown that secondhand smoke causes thousands of deaths each year from lung cancer and heart disease in healthy nonsmokers.

Smoking by mothers is linked to a higher risk of their babies developing asthma in childhood, especially if the mother smokes while pregnant. It is also associated with sudden infant death syndrome (SIDS) and low-birth weight infants. Babies and children raised in a household where there is smoking have more ear infections, colds, bronchitis, and other respiratory problems than children from nonsmoking families. Secondhand smoke can also cause eye irritation, headaches, nausea, and dizziness.

Setting an Example

If you have children, you probably want to set a good example for them. When asked, nearly all smokers say they don't want their children to smoke, but children whose parents smoke are more likely to start smoking themselves. You can become a good role model for them by quitting now.

Ear Pain

2007-01-23T18:58:00.000-05:00

An earache can be sharp, dull, or burning pain. The pain may be temporary or constant.

Considerations

Ear pain in children is often caused by a build-up of fluid and pressure behind the eardrum, in the area called the middle ear. The middle ear is connected to the nasal passages by a short narrow tube, the Eustachian tube. The Eustachian tube allows normal fluids to drain out of the middle ear, and helps keep the pressure in your ear equalized.

A cold or allergy can block the Eustachian tube due to inflammation and the build-up of secretions. This is especially likely in small children, because their Eustachian tube is shorter and more horizontal. When the Eustachian tube closes, the normal flow of fluid from the middle ear is prevented. The fluid begins to accumulate, which can cause stuffiness, pain,hearing loss, and an ear infection.

The symptoms of an ear infection may include fever , ear pain, fussiness, increased crying, and irritability. Many children will have temporary and minor hearing loss during and right after an ear infection. Permanent hearing loss is rare, but the risk increases the more infections a child has.

Ear pain in a child or infant is not always from infection, however. Other causes include water from bathing, soap or shampoo retention, or ear canal irritation from cotton-tipped swabs.

Ear pain in adults is less likely to be from an ear infection. What you perceive as ear pain may actually be coming from another location, such as your temporomandibular joint, your teeth, throat, or other location. This is called "referred" pain.

Common Causes

An object in the ear or severely impacted ear wax.
An ear infection
- Acute Middle Ear Infection (short and severe episode)
- Chronic Middle Ear Infection (does not go away or recurs)
- Acute Outer ear (canal) infection
- Chronic Outer Ear (canal) Infection
- Outer Ear Infection (Malignant)
Ear injuries from pressure changes (from high altitudes and other causes)
Perforated or Ruptured Ear drum
Tooth Infection
Sinus Infection
Arthritis of the Jaw
Sore Throat with referred pain to the ears
Temporomandibular Joint Syndrome(TMJ)

The following steps may help an earache:

Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can provide relief for children and adults with an earache. (Do NOT give aspirin to children .)
A cold pack or cold wet wash cloth applied to the outer ear for 20 minutes may reduce pain.
Olive oil or over-the-counter ear drops are gentle and effective, as long as the eardrum has not ruptured. Prescription drops, such as Auralgan, are also effective at pain relief.
For children old enough to safely chew gum, chewing may help relieve the pain and pressure of an ear infection.
If a child is uncomfortable lying down, resting in an upright position may help reduce pressure in the middle ear.

Ear pain caused by rapidly descending from high altitudes can be relieved by swallowing, chewing gum, or other methods. Allowing infants to suck on a bottle during descent can help.

Call your health care provider if:

For children, call your child's doctor if:

The child's symptoms (pain, fever, or irritability) do not improve within 24 to 48 hours
At the start, the child seems sicker than just an ear infection
Your child has a high fever or severe pain
Severe pain suddenly stops hurting -- this may indicate a ruptured eardrum
Symptoms worsen
New symptoms appear, especially severe headache, dizziness, swelling around the ear, or weakness of the face muscles

What to expect at your health care provider's office:

The doctor will perform a physical exam, which may include examination of the ear, nose, mastoid (bony part behind the ear), and throat. Pain, tenderness, or redness of the mastoid often indicates a serious infection.

During the examination, the doctor will ask questions about the ear pain, such as:

When did it begin?
Is it getting better, worse, or staying the same?
Is the pain constant?
What other symptoms are also present?
Is there ear pressure?
Is there drainage from ears?
Are there unusual ear noises?
Is there a fever?
Is there pain in the bone behind the ear?
Is there hearing loss?

Because most ear infections improve within 24 hours of seeing a doctor, physicians are less likely to prescribe antibiotics immediately, often waiting to see if symptoms persist or progress. This strategy has been shown to reduce antibiotic usage.

If antibiotics are prescribed, it is important to take ALL of the prescribed antibiotic on schedule. Ear tubes may be inserted for children who have persistent or recurring ear infections, to re-establish the proper functioning of the middle ear. Inserting ear tubes is a simple and effective surgical procedure.

Prevention

The following steps may help prevent earaches:

Avoid smoking near children. Smoking has been shown to cause millions of ear infections each year in children.
Take steps to control allergies. In particular, avoid allergy triggers. Steroid nasal spray may help reduce ear infections. However, over-the-counter sedating antihistamines and decongestants do NOT prevent ear infections.
Outer ear infections can be prevented by not putting objects in the ear, and drying the ear after bathing or swimming.

Stress and Anxiety

2007-01-23T00:05:00.000-05:00

What is Anxiety?

Anxiety can be a normal "alarm system" alerting you to danger. Imagine coming home and finding a burglar in your living room. Your heart beats fast. Your palms get sweaty. Your mind races. In this situation, anxiety can provide an extra spark to help you get out of danger. In more normal but busy situations, anxiety can give you the energy to get things done.

But sometimes anxiety can be out of control, giving you a sense of dread and fear for no apparent reason. This kind of anxiety can disrupt your life.

Anxiety can be a general feeling of worry, a sudden attack of panicky feelings, or a fear of a certain situation or object.

Types of Anxiety Disorders:

1. Generalized Anxiety Disorder:

Generalized anxiety disorder is ongoing worry or fear that isn't related to a particular event or situation, or is out of proportion to what you would expect--for instance, constantly worrying about a child who is perfectly healthy.

Symptoms of generalized anxiety disorder include muscle tension, trembling, shortness of breath, fast heartbeat, dry mouth, dizziness, nausea, irritability, loss of sleep and not being able to concentrate.

2. Panic Disorder:

Panic disorder is another type of anxiety. It occurs when you have repeated periods of extreme panic, called panic attacks.

Suppose one day you're getting out of your car to go to work. Suddenly, your chest feels tight. Your heart races. You begin to feel dizzy and faint. You start to choke. You feel as if the end is near. Was it all in your head? No. Most likely, you had a panic attack.

Panic attacks last about 5 to 30 minutes and may include any of the symptoms listed in the box below. Panic attacks can lead to phobias if they aren't treated.

Am I having a panic attack?

Feeling like you're going to choke
Chest pressure or chest pain
Pounding heart
Racing pulse
Dizziness or lightheadedness
Shortness of breath or tightness in the throat
Sweating
Trembling or shaking
Nausea
Tingling or numbness in the hands or feet
Hot flashes or chills
Sense of unreality or dreamlike sensations
Extreme fear of losing control, doing something embarrassing, going "crazy" or dying

Phobias:

A phobia is an extreme, unreasonable fear in response to something specific. There are lots of different phobias, including fear of crowds, bridges, snakes, spiders, heights, open places or social embarrassment.

A phobia is only considered a problem when it keeps you from living a normal life. An example is being afraid to leave home because you are afraid of one of the things listed above.

Cause of Anxiety disorders:

Suppose the fire alarm goes off in your home. You race around frantically to find the fire. Instead, you find that there is no fire--the alarm just isn't working properly.

It's the same with anxiety disorders. Your body mistakenly triggers your alarm system when there is no danger. This may be due to a chemical imbalance in your body. It may also be related to an unconscious memory, to a side effect of a medicine or to an illness.

Treatment: Talk to your family doctor if you think you have an anxiety disorder. He or she can help you form a plan to develop skills to cope with your anxiety. Your doctor may also suggest counseling and prescribe medicine if needed. The following are some tips on coping with anxiety:

a) Control your worry. Pick a place and time to do your worrying. Make it the same place and time every day. Spend 30 minutes thinking about your concerns and what you can do about them. Try not to dwell on what "might" happen. Focus more on what's really happening. Then let go of the worry and go on with your day.

b) Learn ways to relax. These may include muscle relaxation, yoga, or deep breathing (see box to the right).

Muscle relaxation is simple. Start by choosing a muscle and holding it tight for a few seconds. Then relax the muscle. Do this with all of your muscles. Try starting with your feet muscles and working your way up your body.

c) Exercise regularly. People who have anxiety often quit exercising. But exercise can give you a sense of well-being and help decrease feelings of anxiety.

d) Get plenty of sleep.

e) Avoid alcohol and drug abuse. It may seem that alcohol or drugs relax you. But in the long run they make anxiety worse and cause more problems.

f) Avoid caffeine. Caffeine is found in coffee, tea, soft drinks and chocolate. Caffeine may increase your sense of anxiety because it stimulates your nervous system. Also avoid over-the-counter diet pills, and cough and cold medicines the contain a decongestant.

g) Confront the things that have made you anxious in the past. Begin by just picturing yourself confronting these things. By doing this, you can get used to the idea of confronting the things that make you anxious before you actually do it. After you feel more comfortable picturing yourself confronting these things, you can begin to actually face them.

If you feel yourself getting anxious, practice a relaxation technique or focus on a simple task, such as counting backward from 100 to 0.

Although feelings of anxiety are scary, they won't hurt you. Label the level of your fear from 0 to 10 and keep track as it goes up and down. Notice that it doesn't stay at a very high level for more than a few seconds. When the fear comes, accept it. Wait and give it time to pass without running away from it.

h) Use medicine if it helps. Your doctor may give you medicine to help reduce your anxiety while you learn new ways to respond to the things that make you anxious. Many types of medicine are available. Your doctor will decide which medicine is right for you.

i) Talk about your anxiety with your doctor. Your doctor can help you make a plan to cope with anxiety. Counseling can help you learn to express your needs and wants so you can feel more in control and hold in less of your anger and anxiety.

The most important thing is to take action. Any action you take will help you gain a sense of control over your anxiety.

Dog Bites....What you should be aware of....

2007-01-22T11:20:00.000-05:00

Regarding Dogs...

Most dogs will never bite anyone. However, any dog may bite if it feels threatened. Children are the most common victims of dog bites. Infants and young children should never be left alone with a dog. This handout tells you how to teach your children to avoid getting bitten.

Take time to learn about the breed of dog you want. To learn about dog breeds, talk with a veterinarian, read books about dogs and search the Internet. Don’t get a dog only because of the way it looks. If you have an infant or young child, think about getting a puppy. Be especially careful if you have a baby in your house. Aggressive dog breeds aren’t right for families with children. Neutered male dogs are generally less aggressive.

Consider taking your new dog to obedience school. Keep your dog’s immunizations up to date. Have your dog checked regularly by a veterinarian.

Don’t go near strange dogs.

What I should tell my kids:

Never bother a dog that is eating, sleeping or caring for puppies.
Tell an adult about any stray dogs.
Always have an adult with you when you play with a dog.
Never tease a dog.
Never pet a dog without first letting it smell you.

What should you do if a dog approaches you:

Don’t run away and scream.
Stand very still, “like a tree.”
Avoid making direct eye contact with the dog.
If you fall or are knocked down, act “like a log.”
When the dog understands that you are not a threat, it will probably walk away.
If a dog bites you, tell an adult right away.

A dog is a wonderful addition to a family, but it can be a problem if you aren’t careful. Always talk to children about how they should act when they’re with a dog. Remember that dogs can feel threatened by new surroundings or strangers.

Allergies

2007-01-22T11:08:00.000-05:00

What are allergies?

Allergies are the immune system’s incorrect response to a foreign substance. Exposure to what is normally a harmless substance, such as pollen, causes the immune system to react as if the substance is harmful. Substances that cause allergies are called allergens.

When you come into contact with an allergen, you may experience a number of allergic symptoms including itchy, watery nose and eyes; asthma symptoms such as wheezing and coughing; or hives.

What is an allergic reaction?

A hypersensitive response, or allergic "reaction," is the result of how three factors interact with the body:

1. The allergen — Allergens include pollen, mold, dust mites, certain foods, latex, animal dander, and others.

2. Mast cells — Although mast cells are found throughout the body, most reside in connective tissues such as those of the skin, tongue, the lining of the nose and intestinal tract, the lungs, and upper airways.

3. Immunoglobulin E (IgE) — IgE is an allergic antibody, a type of protein made by the immune system to recognize and fight specific body "invaders." IgE coats the surface of the mast cells in tissues.

The first time an allergy-prone person is exposed to an allergen (such as pollen), large amounts of the corresponding IgE antibodies (for example, pollen IgE antibodies) are produced. The IgE antibodies cause the mast cells to release inflammatory chemicals that cause swelling of tissues, as well as histamine and several other chemicals that cause itching, engorgement of blood vessels, increased secretions, and bronchospasm (tightening of muscles that surround the airways). Some of these chemicals attract white blood cells known as eosinophils. The eosinophils add more inflammatory chemicals.

If the allergen is in the air, the allergic reaction will occur in the eyes, nose and lungs. If the allergen is ingested, the allergic reaction will occur in the mouth, stomach, and intestines. Sometimes enough inflammatory chemicals are released to cause a reaction throughout the body, such as hives, decreased blood pressure, shock, or loss of consciousness. This severe type of reaction is called anaphylaxis and may be life-threatening.

What are the symptoms of allergies?

Allergy symptoms can be categorized as mild, moderate, or severe (anaphylactic).

Mild reactions include local symptoms (affecting a specific area of the body) such as a rash or hives; itchy, watery eyes; and some congestion. Mild reactions do not spread to other parts of the body.
Moderate reactions include symptoms that spread to other parts of the body. Symptoms may include itchiness that spreads or difficulty breathing.
A severe allergic reaction, known as anaphylaxis, is a rare, life-threatening emergency in which the body’s response to the allergen is sudden and affects the whole body (systemic). Anaphylaxis may begin with severe itching of the eyes or face and within minutes progresses to more serious symptoms, including swelling (which could result in difficulty swallowing and breathing); abdominal pain; cramps; vomiting; diarrhea; hives; and angioedema (hives in the throat). Mental confusion or dizziness also may be symptoms, since anaphylaxis causes a quick drop in blood pressure.

Types of allergies

People can be allergic to a wide variety of substances, the most common of which are pollen and dust mites. Airborne allergens include:

Pollen
Allergic rhinitis, or hay fever, is the allergic response to pollen. It causes inflammation and swelling of the lining of the nose, as well as the protective tissue of the eyes (conjunctiva).

Symptoms include sneezing, congestion, and itchy, watery eyes. Treatment options include over-the-counter and prescription antihistamines, nasal steroids, and nasal cromolyn. Other ways to help reduce symptoms include avoiding pollen exposure by staying indoors when pollen counts are high, and closing windows and using air conditioning. Immunotherapy, or allergy shots, also may be used to treat pollen allergies.

Dust mites
Dust mites are microscopic organisms that live in dust and in the fibers of household objects not frequently laundered, such as pillows, mattresses, carpet, and upholstery. Dust mites especially love warm, humid areas. House dust is a mixture of potentially allergenic materials, including fibers from different fabrics, dander from animals, bacteria, mold or fungus spores, food particles, bits of plants, or other allergens.

The symptoms of dust mite allergy are similar to those of pollen allergy, and also can produce symptoms of asthma such as wheezing and coughing. To help manage dust mite allergies, try using dust mite covers (airtight plastic/polyurethane covers) over pillows, mattresses, and box springs. Also, remove carpeting or vacuum frequently using a vacuum cleaner with high-efficiency filters. Treatment may include medications such as antihistamines or decongestants. Immunotherapy may be recommended for people whose symptoms are chronic (ongoing).

Molds
Molds are parasitic, microscopic fungi (like Penicillium) with spores that float in the air like pollen. Mold is a common trigger for allergies and can be found in damp areas, such as the basement or bathroom, as well as in the outdoor environment in grass, leaf piles, hay, mulch, or under mushrooms. In some people, symptoms of mold allergy may be brought on or made worse by eating certain foods, such as cheese processed with fungi. Mold spores peak during hot, humid weather.

Symptoms include sneezing; congestion; itchy, watery eyes; runny nose; and coughing. Treatment options include antihistamines, nasal steroid sprays, and immunotherapy.

Animal dander
The proteins secreted by oil glands in an animal’s skin, which are shed in dander, and the proteins present in an animal’s saliva cause allergic reactions in some people. Allergies to animals can take two or more years to develop, and symptoms may not subside until months after ending contact with the animal.

Symptoms include sneezing, congestion, and itchy, watery eyes. Treatment involves avoiding exposure to the animals that cause your allergies. Medications such as antihistamines or decongestants may be helpful. Immunotherapy may be recommended if you have severe symptoms from intermittent exposure.

Other allergens include:

Latex
A latex allergy develops after some sensitizing contact with latex. Rubber gloves are the main source of allergic reactions. A component of the latex substance itself is an allergen for many people. The latex glove powder residue is an airborne allergen that causes upper airway allergic reactions in some people, as well as worsening asthma.

Skin rash, hives, eye tearing and irritation, wheezing, and itching of the skin are common symptoms of latex allergy. Allergic reactions to latex can range from skin redness and itching to much more serious symptoms. A more severe reaction can occur if there is extensive exposure of the mucosal membrane, such as during an operation or gynecologic exam.

Treatment of latex reactions begins by removing the offending latex product. Drug treatment also may be used, according to the type of symptoms developing. If you have latex allergy, it is important for you to wear a Medic Alert bracelet and carry an emergency epinephrine kit. There is no cure for latex allergy, so the best treatment for this condition is prevention.

Certain foods
Food allergies develop when there is an IgE antibody to a specific food. An allergic reaction occurs within minutes of eating the food, and symptoms can be severe. Shellfish, peanuts, and tree nuts are the most common food allergies in adults. Milk, eggs, soy, wheat, shellfish, peanuts, and tree nuts are the most common food allergies in children. Non-allergic food intolerance is more common than true food allergy.

Symptoms of food allergy include asthma (wheezing, coughing), hives, runny nose, vomiting, diarrhea, and swelling in the area around the mouth. The best treatment is to avoid the foods that cause allergy symptoms. For rashes, skin creams may ease discomfort, while antihistamines will help reduce itching, congestion, and other symptoms. For more serious reactions, corticosteroids such as prednisone will help to reverse severe generalized symptoms. In life-threatening situations, an epinephrine (adrenaline) injection immediately begins reversing symptoms and is the only effective treatment option.

Insect venom (stings)
If stung by a bee, the bee usually leaves a sac of venom and a stinger in the victim's skin. If the sac is still in the skin, gently scrape it out with a fingernail or a stiff-edged object like a credit card. Do not pull on the stinger, as this will cause the release of more venom into the skin.

A normal reaction will result in pain, swelling, and redness around the sting site. A large, local reaction will result in swelling that extends beyond the sting site. For example, a person stung on the ankle may have swelling of the entire leg. The most serious reaction to an insect sting is an allergic one, requiring immediate medical attention. Symptoms of an allergic reaction to an insect sting include difficulty breathing; hives that appear as a red, itchy rash that spreads to areas other than the immediate area stung; swelling of the face, throat, or mouth tissue; wheezing or difficulty swallowing; restlessness and anxiety; rapid pulse; and dizziness or a sharp drop in blood pressure.

Take an oral antihistamine, such as Benadryl, to reduce itching, local swelling, and hives. To relieve pain, take aspirin or an aspirin-substitute. An allergic reaction is treated with epinephrine (adrenaline), either self-injected or administered by a doctor. Usually, this injection will stop the development of severe allergic reaction.

What is allergic rhinitis?

Nasal allergy symptoms and hay fever are referred to as "allergic rhinitis." Seasonal allergic rhinitis describes nasal allergies that change with the seasons due to pollen from plants (trees, grasses, or weeds). Seasonal symptoms arise during the pollinating seasons for particular plants. Because you can be allergic to more than one thing, your symptoms may get worse at different times throughout the year, or they may appear constant (perennial).

Does everyone get allergies?

No. Most allergies are inherited, which means they are passed on to children by their parents. People inherit a tendency to be allergic, although not to any specific allergen. If a child develops an allergy, it is very likely that at least one of his or her parents has allergies. Being exposed to allergens at certain times when the body’s defenses are low or weak, such as after a viral infection or during pregnancy, also may contribute to the development of allergies.

How common are allergies?

Allergic disorders affect more than 20 percent of adults and children (40 to 50 million people) and are the sixth leading cause of chronic illness in the United States, according to the Allergy Report from the American Academy of Allergy, Asthma and Immunology.

How are allergies diagnosed?

If you think you have allergies, don’t wait to see if your symptoms will go away. When your symptoms last longer than a week or two and tend to recur, make an appointment with your doctor so a complete medical evaluation can be performed.

An allergy skin test, also called a prick test, may be used to identify the substances that are causing your allergy symptoms. The test is performed by pricking your skin with an extract of an allergen, and then evaluating the skin’s reaction.

If a skin test cannot be performed, a radioallergosorbent blood test (RAST) may be taken, although its results are not as accurate as a skin test. This RAST evaluates the number of antibodies produced by the immune system. Elevated levels of certain antibodies can identify particular allergies.

How are allergies treated?

Medications such as antihistamines, decongestants, or a combination of both are available over-the-counter or by prescription to treat allergy symptoms. Nasal sprays such as topical nasal steroids and cromolyn sodium also can be used to treat allergy symptoms. Immunotherapy, or allergy shots, is recommended for relief that is needed over a long period of time.

Can allergies be prevented?

Allergies cannot be prevented, but they can be treated and controlled. Making changes in your environment can greatly limit your exposure to certain allergens and reduce your symptoms.

Dehydration

2007-01-22T01:40:00.000-05:00

What is Dehydration?

Dehydration is a condition that occurs when a person loses more fluids than he or she takes in. Dehydration isn't as serious a problem for teens as it can be for babies or young children. But if you ignore your thirst, dehydration can slow you down.

Our bodies are about two thirds water. When someone gets dehydrated, it means the amount of water in his or her body has dropped below the level needed for normal body function. Small decreases don't cause problems, and in most cases, they go completely unnoticed. But losing larger amounts of water can sometimes make a person feel quite sick.

Causes of Dehydration:

One common cause of dehydration in teens is gastrointestinal illness. When you're flattened by a stomach bug, you lose fluid through vomiting and diarrhea.

You might also hear that you can get dehydrated from playing sports. In reality, it's rare to reach a level of even moderate dehydration during sports or other normal outdoor activity. But if you don't replace fluid you lose through sweat as you go, you can become dehydrated from lots of physical activity, especially on a hot day.

Some athletes, such as wrestlers who need to reach a certain weight to compete, dehydrate themselves on purpose to drop weight quickly before a big game or event by sweating in saunas or using laxatives or diuretics, which make a person go to the bathroom more. This practice usually hurts more than it helps, though. Athletes who do this feel weaker, which affects performance. They can also have more serious problems, like abnormalities in the salt and potassium levels in the body. Such changes can also lead to problems with the heart's rhythm.

Dieting can sap a person's water reserves as well. Beware of diets or supplements, including laxatives and diuretics that emphasize shedding "water weight" as a quick way to lose weight. Losing water weight is not the same thing as losing actual fat.

Signs of Dehydration:

To counter dehydration, you need to restore the proper balance of water in your body. First, though, you have to recognize the problem.

Thirst is one indicator of dehydration, but it is not an early warning sign. By the time you feel thirsty, you might already be dehydrated. Other symptoms of dehydration include:

feeling dizzy and lightheaded
having a dry or sticky mouth
producing less urine and darker urine

As the condition progresses, a person will start to feel much sicker as more body systems (or organs) are affected by the dehydration.

How do I prevent it?

The easiest way to avoid dehydration is to drink lots of fluids, especially on hot, dry, windy days. Water is usually the best choice. Drinking water does not add calories to your diet and can be great for your health.

The amount that people need to drink will depend on factors like how much water they're getting from foods and other liquids and how much they're sweating from physical exertion.

When you're going to be outside on a warm day, dress appropriately for your activity. Wear loose-fitting clothes and a hat if you can. That will keep you cooler and cut down on sweating. If you do find yourself feeling parched or dizzy, take a break for a few minutes. Sit in the shade or someplace cool and drink water.

If you're participating in sports or strenuous activities, drink some fluids before the activity begins. You should also drink at regular intervals (every 20 minutes or so) during the course of the activity and after the activity ends. The best time to train or play sports is in the early morning or late afternoon to avoid the hottest part of the day.

If you have a stomach bug and you're spending too much time getting acquainted with the toilet, you probably don't feel like eating or drinking anything. But you still need fluids. Take lots of tiny sips of fluids. For some people, ice pops may be easier to tolerate.

Staying away from caffeine in coffee, sodas, and tea can also help you avoid dehydration. Caffeine is a diuretic (it makes you urinate more frequently than you usually need to).

Do I need to see my doctor?

Dehydration can usually be treated by drinking fluids. But if you faint or feel weak or dizzy every time you stand up (even after a couple of hours) or if you have very little urine output, you should tell an adult and visit your doctor. The doctor will probably look for a cause for the dehydration and encourage you to drink more fluids. If you're more dehydrated than you realized, especially if you can't hold fluids down because of vomiting, you may need to receive fluids through an IV to speed up the rehydration process. An IV is an intravenous tube that goes directly into a vein.

Occasionally, dehydration might be a sign of something more serious, such as diabetes, so your doctor may run tests to rule out any other potential problems.

In general, dehydration is preventable. So just keep drinking that H2O for healthy hydration.

Migraine

2007-01-22T01:36:00.000-05:00

A migraine is a type of primary headache that some people get repeatedly over time. Migraines are different from other headaches because they occur with symptoms such as nausea, vomiting, or sensitivity to light. In most people, a throbbing pain is felt only on one side of the head.

Migraines are classified as either "with aura" or "without aura." An aura is a group of neurological symptoms, usually vision disturbances that serve as warning sign. Patients who get auras typically see a flash of brightly colored or blinking lights shortly before the headache pain begins. However, most people with migraines do not have such warning signs

Causes of Migraine

A lot of people get migraines -- about 11 out of 100. The headaches tend to start between the ages of 10 and 46 and may run in families. Migraines occur more often in women than men. Pregnancy may reduce the number of migraines attacks. At least 60 percent of women with a history of migraines have fewer such headaches during the last two trimesters of pregnancy.

Until the 1980s, scientists believed that migraines were due to changes in blood vessels within the brain. Today, most believe the attack actually begins in the brain itself, and involves various nerve pathways and chemicals in the brain. A migraine attack can be triggered by stress, food, environmental changes, or some other factor. However, the exact chain of events remains unclear.

Migraine attacks may be triggered by:

Allergic reactions
Bright lights, loud noises, and certain odors or perfumes
Physical or emotional stress
Changes in sleep patterns
Smoking or exposure to smoke
Skipping meals
Alcohol or caffeine
Menstrual cycle fluctuations, birth control pills
Tension headaches
Foods containing tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, and some beans), monosodium glutamate (MSG), or nitrates (like bacon, hot dogs, and salami)
Other foods such as chocolate, nuts, peanut butter, avocado, banana, citrus, onions, dairy products, and fermented or pickled foods

Symptoms

Migraine headaches, which can be dull or severe, usually:

Feel throbbing, pounding, or pulsating
Are worse on one side of the head
Last 6 to 48 hours

Symptoms accompanying migraines include:

Nausea and vomiting
Sensitivity to light or sound
Loss of appetite
Fatigue
Numbness, tingling, or weakness

Warning signs (auras) that can precede a migraine include seeing stars or zigzag lines, tunnel vision, or a temporary blind spot.

Symptoms that may linger even after the migraine has gone away include:

Feeling mentally dull, like your thinking is not clear or sharp
Increased need for sleep
Neck pain

Signs and tests

Migraine headache may be diagnosed by your doctor based on your symptoms, history of migraines in the family, and your response to treatment. Your doctor will take a detailed history to make sure that your headaches are not due to tension, sinus inflammation, or a more serious underlying brain disorder. During the physical exam, your doctor will probably not find anything wrong with you.

Sometimes an MRI or CT scan is obtained to rule out other causes of headache like sinus inflammation or a brain mass. In the case of a complicated migraine, an EEG may be needed to exclude seizures. Rarely, a lumbar puncture (spinal tap) might be performed.

Treatment

There is no specific cure for migraine headaches. The goal is to prevent symptoms by avoiding or altering triggers. When you do get migraine symptoms, try to treat them right away. The headache may be less severe.

A good way to identify triggers is to keep a headache diary.

When migraine symptoms begin:

Rest in a quiet, darkened room
Drink fluids to avoid dehydration (especially if you have vomited)
Try placing a cool cloth on your head

Over-the-counter pain medications like acetaminophen, ibuprofen, or aspirin are often helpful, especially when your migraine is mild. (Be aware, however, that chronic usage of such pain medications may result in rebound headaches.) If these don't help, ask your doctor about prescription medications.

Your doctor will select from several different types of medications, including:

Ergots like dihydroergotamine or ergotamine with caffeine (Cafergot)
Triptans like sumatriptan (Imitrex), rizatriptan (Maxalt), almotriptan (Axert), frovatriptan (Frova), and zolmitriptan (Zomig); these are available as a tablet, nasal spray, or self-administered injection
Isometheptene (Midrin)
Stronger pain relievers (narcotics)

Many of the prescription medications for migraines narrow your blood vessels. Therefore, these drugs should not be used if you have heart disease, unless specifically instructed by your doctor.

If you wish to consider an alternative, feverfew is a popular herb for migraines. Several studies, but not all, support using feverfew for treating migraines. If you are interested in trying feverfew, make sure your doctor approves. Also, know that herbal remedies sold in drugstores and health food stores are not regulated. Work with a trained herbalist when selecting herbs.

Headache

2007-01-22T01:31:00.000-05:00

What is Headache?

There are four types of headache: vascular, muscle contraction (tension), traction, and inflammatory. The most common type of vascular headache is migraine. Migraine headaches are usually characterized by severe pain on one or both sides of the head, an upset stomach, and, at times, disturbed vision. Women are more likely than men to have migraine headaches. After migraine, the most common type of vascular headache is the toxic headache produced by fever. Other kinds of vascular headaches include "cluster” headaches, which cause repeated episodes of intense pain, and headaches resulting from high blood pressure. Muscle contraction headaches appear to involve the tightening or tensing of facial and neck muscles. Traction and inflammatory headaches are symptoms of other disorders, ranging from stroke to sinus infection. Like other types of pain, headaches can serve as warning signals of more serious disorders. This is particularly true for headaches caused by inflammation, including those related to meningitis as well as those resulting from diseases of the sinuses, spine, neck, ears, and teeth.

Is there any treatment?

When headaches occur three or more times a month, preventive treatment is usually recommended. Drug therapy, biofeedback training, stress reduction, and elimination of certain foods from the diet are the most common methods of preventing and controlling migraine and other vascular headaches. Regular exercise, such as swimming or vigorous walking, can also reduce the frequency and severity of migraine headaches. Drug therapy for migraine is often combined with biofeedback and relaxation training. One of the most commonly used drugs for the relief of migraine symptoms is sumatriptan. Drugs used to prevent migraine also include methysergide maleate, which counteracts blood vessel constriction; propranolol hydrochloride, which also reduces the frequency and severity of migraine headaches; ergotamine tartrate, a vasoconstrictor that helps counteract the painful dilation stage of the headache; amitriptyline, an antidepressant; valproic acid, an anticonvulsant; and verapamil, a calcium channel blocker.

What is the prognosis?

Not all headaches require medical attention. But some types of headache are signals of more serious disorders and call for prompt medical care. These include: sudden, severe headache or sudden headache associated with a stiff neck; headaches associated with fever, convulsions, or accompanied by confusion or loss of consciousness; headaches following a blow to the head, or associated with pain in the eye or ear; persistent headache in a person who was previously headache free; and recurring headache in children. Migraine headaches may last a day or more and can strike as often as several times a week or as rarely as once every few years.

Vomiting

2007-01-19T11:24:00.000-05:00

Most of the time, vomiting in children is caused by gastroenteritis, usually due to a virus infecting the gastrointestinal tract. (Gastroenteritis is sometimes called the "stomach flu," which can also cause nausea and diarrhea.) These infections often don't last long and are more disruptive than dangerous to your child. However, if kids (especially infants) are unable to take fluids adequately, and if there's also diarrhea, they could become dehydrated.

Your most important intervention may be a calm approach - vomiting is frightening for young children (and parents, too) and exhausting for children of all ages. Offering plenty of reassurance to your child and taking appropriate measures to prevent dehydration are key for a quick recovery.

What to Do When Your Child Is Vomiting

1. For infants under 6 months:

Avoid giving plain water to a young infant unless your child's doctor directly specifies an amount.
Offer your infant small but frequent amounts - about 2 to 3 teaspoons, or up to 1/2 ounce (about 20 milliliters) - of an oral electrolyte solution every 15 to 20 minutes with a spoon or an oral syringe. Oral electrolyte solutions (available at most supermarkets or pharmacies and also called oral electrolyte maintenance solutions) are balanced with salts to replace what's lost with vomiting or diarrhea, and they also contain some sugar. It's especially important for young infants that any fluids given have the correct salt balance (unflavored electrolyte solutions are best for younger infants).
Gradually increase the amount of solution you're giving if your infant is able to keep it down for more than a couple of hours without vomiting. For instance, if your little one takes 4 ounces (or about 120 milliliters) normally per feed, slowly work up to giving this amount of oral electrolyte solution over the course of the day.
Do not give more solution at a time than your infant would normally eat - this will overfill an already irritated tummy and will likely cause more vomiting.
After your infant goes for a period of time (more than about 8 hours) without vomiting, you can reintroduce formula slowly if your infant is formula-fed. Start with small (1/2 to 1 ounce, or about 20 to 30 milliliters), more frequent feeds and slowly work up to your infant's normal feeding routine. If your infant already eats baby cereal, it's OK to start solid feedings in small amounts again.
If your infant is exclusively breastfeeding and vomits (not just spits up, but vomits what seems like the entire feed) more than once, then breastfeed for a total of 5 to 10 minutes every 2 hours. If your infant is still vomiting, then call your child's doctor. After 8 hours without vomiting, you can resume breastfeeding normally.
If your infant is under 1 month old and vomiting all feeds (not just spitting up), call your child's doctor immediately.

2. For infants 6 months to 1 year:

Avoid giving plain water to an infant under 1 year, unless an amount is directly specified by your child's doctor.
Give your infant small but frequent amounts - about 3 teaspoons, or 1/2 ounce (about 20 milliliters) - of an oral electrolyte solution every 15 to 20 minutes. It's important that any fluids given to infants under 1 year of age who are vomiting have the correct salt balance (again, oral electrolyte solutions are balanced with salts to replace what's lost with vomiting or diarrhea).
An infant over 6 months of age may not appreciate the taste of an unflavored oral electrolyte solution. Flavored solutions are also available, or you can add 1/2 teaspoon (about 3 milliliters) of juice to each feeding of unflavored oral electrolyte solutions. Frozen oral electrolyte solution pops are often appealing to infants in this age group; this approach also encourages the slow intake of fluids that's required.
Gradually increase the amount of solution you're giving if your infant is able to keep it down for more than a couple of hours without vomiting. For instance, if your infant takes 4 ounces (about 120 milliliters) normally per feed, work slowly up to giving this amount of oral electrolyte solution over the course of the day.
Do not give more solution at a time than your infant would normally eat - this will overfill an already irritated tummy and will likely cause more vomiting.
After your infant goes more than about 8 hours without vomiting, you can reintroduce formula slowly to your infant. Start with small (1 to 2 ounces, or about 30 to 60 milliliters), more frequent feeds and slowly work up to your infant's normal feeding routine. You can also begin small amounts of soft, bland foods that your infant is already familiar with such as bananas, cereals, crackers, or other mild baby foods.
If your infant doesn't vomit for 24 hours, you can resume your normal feeding routine.

3. For children 1 year or older:

Give clear liquids (milk and milk products should be avoided) in small amounts (ranging from 2 teaspoons to 2 tablespoons, or up to 1 ounce or 30 milliliters) every 15 minutes. Clear liquids that are appropriate include:
- ice chips or sips of water
- flavored oral electrolyte solutions, or add 1/2 teaspoon (about 3 milliliters) of nonacidic fruit juice to the oral electrolyte solution
- frozen oral electrolyte solution pops
If your child vomits, then start over with a smaller amount of fluid (2 teaspoons, or about 5 milliliters) and continue as above.
If there's no vomiting for approximately 8 hours, then introduce bland, mild foods gradually. But do not force any foods - your child will tell you when he or she is hungry. Saltine crackers, toast, broths, or mild soups (some noodles are OK), mashed potatoes, rice, and breads are all OK.
If there's no vomiting for 24 hours, then you can slowly resume your child's regular diet. Wait 2 to 3 days before resuming milk products.

When Should You Call Your Child's Doctor?

The greatest risk of vomiting due to gastroenteritis (the "stomach flu") is dehydration. Call your child's doctor if your child refuses fluids or if the vomiting continues after using the suggestions above. Call your child's doctor for any of the signs of dehydration listed below.

Mild to moderate dehydration:

dry mouth
few or no tears when crying
fussy behavior in infants
fewer than four wet diapers per day in an infant (more than 4 to 6 hours without a wet diaper in a younger infant under 6 months of age)
no urination for 6 to 8 hours in children
soft spot on an infant's head that looks flatter than usual or somewhat sunken

Severe dehydration:

very dry mouth (looks "sticky" inside)
dry, wrinkled, or doughy skin (especially on the belly and upper arms and legs)
inactivity or decreased alertness
appears weak or limp
sunken eyes
sunken soft spot in an infant
excessive sleepiness or disorientation
deep, rapid breathing
no urination for more than 6 to 8 hours in infants
no urination for more than 8 to 10 hours in children
fast or weakened pulse

The following symptoms may indicate a condition more serious than gastroenteritis and indicate that you need to contact your child's physician:

projectile or forceful vomiting in an infant, particularly a baby who's less than 3 months old
vomiting in an infant after the infant has taken an oral electrolyte solution for close to 24 hours
vomiting starts again as soon as you try to resume the child's normal diet
vomiting starts after a head injury
vomiting is accompanied by fever (100.4 degrees Fahrenheit, or 38 degrees Celsius, rectally in an infant under 6 months of age or more than 101 to 102 degrees Fahrenheit, or 38.3 to 38.9 degrees Celsius, in an older child)
vomiting of bright green or yellow-green fluid
your child's belly feels hard, bloated, and painful between vomiting episodes
vomiting is accompanied by severe stomach pain
vomit resembles coffee grounds (blood that mixes with stomach acid will be brownish in color and look like coffee grounds)
vomiting blood

Sore Throat

2007-01-19T11:02:00.000-05:00

What causes sore throats?

Sore throats can be caused by many things. Viruses (like those that cause colds) can lead to a sore throat. Bacteria can also cause a sore throat, as can smoking, breathing polluted air, drinking alcohol, and hay fever and other allergies.

What is tonsillitis?

Tonsillitis means swelling of the tonsils (at the back of your mouth on each side of your throat). It can cause a sore throat and other symptoms. Signs of strep throat and tonsillitis are often alike (see the box below). Tonsillitis is usually caused by bacteria, though sometimes a virus may be involved.

Symptoms of tonsillitis or strep throat

Sore throat
Fever
Headache
Vomiting
White patches in your throat or on your tonsils
Pain when you swallow
Swollen, red tonsils
Sore glands in your jaw and throat

If I have tonsillitis, will I need a tonsillectomy?

Tonsillectomy is a surgery used to remove tonsils. Most people who have tonsillitis don't need a tonsillectomy. You might need a tonsillectomy if you get severe tonsillitis a lot or if your tonsils are too large and cause problems with your breathing. Your doctor can tell you if a tonsillectomy is needed.

What is strep throat?

Strep throat is caused by a type of bacteria called Streptococcus. The pain of strep throat often feels much like sore throats caused by other bacteria or by viruses. What's important and different about strep throat is that if it isn't treated it can sometimes result in rheumatic fever, which can damage the valves of the heart.

What is mononucleosis?

Mononucleosis (mono) is a viral infection caused by the Epstein-Barr virus. One of the main signs of mono is a sore throat that may last for 1 to 4 weeks. Other signs include swollen glands in your neck, armpits and groin, fever and chills, headache, and feeling tired.

What tests may be used to find the cause of my sore throat?

Your doctor may do a rapid strep test, a throat culture or both. A rapid strep test will give results fast--usually within about 15 minutes. But the test won't tell if your sore throat is caused by a bacterium other than Streptococcus or if it's caused by a virus. A throat culture takes longer--about 24 hours--but it's more accurate. If your doctor thinks you may have mono, he or she will probably do a blood test.

What is the treatment for a sore throat caused by bacteria?

If your sore throat is caused by Streptococcus, your family doctor will probably prescribe penicillin, taken by mouth for 10 days. Another antibiotic, called erythromycin, can be used if you're allergic to penicillin. If your sore throat is caused by a different bacteria, your doctor may prescribe another type of antibiotic.

What is the treatment for a sore throat caused by a virus?

Antibiotics don't work against viruses. Infections caused by viruses usually just have to run their course. Most symptoms caused by a cold-type virus go away in a week to 10 days.

Symptoms caused by mono can last for 4 weeks or more. If you have mono, your doctor will probably suggest that you get plenty of rest and that you not exercise too hard. You can take acetaminophen (brand name: Tylenol), ibuprofen (brand names: Advil, Motrin, Nuprin) or naproxen (brand name: Aleve) for the headache and other aches.

How can I avoid catching or passing a sore throat?

The best ways to avoid catching or passing the viruses and bacteria that can lead to a sore throat are to wash your hands regularly, avoid touching your eyes or mouth, and cover your mouth when coughing or sneezing.

What about a sore throat that's caused by allergies?

If a sore throat is a symptom of hay fever or another allergy, your doctor can help you figure out how to avoid the things that trigger your allergies. Or you may need to take medicine for your allergies.

Easing the pain of a sore throat

Take acetaminophen, ibuprofen or naproxen.
Gargle with warm salt water (1 teaspoon of salt per glass of water).
Suck on throat lozenges or hard candy.
Suck on flavored frozen desserts (such as Popsicles).
Use a humidifier in your bedroom or other rooms you spend lots of time in.
Drink lots of liquids

Poisoning-First Aid

2007-01-19T10:57:00.000-05:00

Many conditions mimic the signs and symptoms of poisoning, including seizures, alcohol intoxication, stroke and insulin reaction. So look for the signs and symptoms listed below if you suspect poisoning, but check with the Poison Control Center at (800) 222-1222 (in the United States) before giving anything to the affected person.

Signs and symptoms of poisoning:

Burns or redness around the mouth and lips, which can result from drinking certain poisons
Breath that smells like chemicals, such as gasoline or paint thinner
Burns, stains and odors on the person, on his or her clothing or on the furniture, floor, rugs or other objects in the surrounding area
Empty medication bottles or scattered pills
Vomiting, difficulty breathing, sleepiness, confusion or other unexpected signs

When to call for help:

Call 911 (or your local emergency number) immediately if the person is:

Drowsy or unconscious
Having difficulty breathing or has stopped breathing
Having seizures

If the person seems stable and has no symptoms, but you suspect poisoning, call the Poison Control Center at (800) 222-1222. Provide information about the person's symptoms and, if possible, information about what he or she ingested, how much and when.

What to do while waiting for help:

If the person has been exposed to poisonous fumes, such as carbon monoxide, get him or her into fresh air immediately.
If the suspected poison is a household cleaner or other chemical, read the label and follow instructions for accidental poisoning. If the product is toxic, the label will likely advise you to call the Poison Control Center at (800) 222-1222. Also call this 800 number if you can't identify the poison, if it's medication or if there are no instructions.
Follow treatment directions that are given by the Poison Control Center.
If the poison spilled on the person's clothing, skin or eyes, remove the clothing. Flush the skin or eyes with cool or lukewarm water, such as by using a shower for 20 minutes or until help arrives.
Take the poison container (or any pill bottles) with you to the hospital.

What NOT to do

Don't administer ipecac syrup or do anything to induce vomiting. In 2003, the American Academy of Pediatrics advised discarding ipecac in the home, saying there's no good evidence of effectiveness and that it can do more harm than good.

Asthma

2007-01-18T17:05:00.000-05:00

Alternative names

Bronchial asthma; Exercise-induced asthma

Definition

Asthma is an inflammatory disorder of the airways, which causes attacks of wheezing, shortness of breath, chest tightness, and coughing.

Causes, incidence, and risk factors

Asthma is caused by inflammation in the airways. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swell. This reduces the amount of air that can pass by, and can lead to wheezing sounds.

Most people with asthma have wheezing attacks separated by symptom-free periods. Some patients have long-term shortness of breath with episodes of increased shortness of breath. Still, in others, a cough may be the main symptom. Asthma attacks can last minutes to days and can become dangerous if the airflow becomes severely restricted.

In sensitive individuals, asthma symptoms can be triggered by breathing in allergy-causing substances (called allergens or triggers). Triggers include pet dander, dust mites, cockroach allergens, molds, or pollens. Asthma symptoms can also be triggered by respiratory infections, exercise, cold air, tobacco smoke and other pollutants, stress, food, or drug allergies. Aspirin and other non-steroidal anti-inflammatory medications (NSAIDS) provoke asthma in some patients.

Approximately 20.5 million Americans currently have asthma. Many people with asthma have an individual or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies.

Symptoms

Wheezing
- Usually begins suddenly
- Comes in episodes
- May be worse at night or in early morning
- Gets worse with cold aira, exercise, and heartburn (reflux)
- May go away on its own
- Is relieved by bronchodilators (drugs that open the airways)
Cough with or without sputum (phlegm) production
Shortness of breath that gets worse with exercise or activity
Intercostal retractions (pulling of the skin between the ribs when breathing)

Emergency symptoms:

Extreme difficulty breathing
Bluish color to the lips and face
Severe anxiety due to shortness of breath
Rapid pulse
Sweating
Decreased level of alertness, such as severe drowsiness or confusion, during an asthma attack

Additional symptoms that may be associated with this disease:

Nasal flaring
Chest pain
Tightness in the chest
Abnormal breathing pattern --breathing out takes more than twice as long as breathing in
Breathing temporarily stops

Signs and tests

Allergy testing may be helpful in identifying allergens in patients with persistent asthma. Common allergens include pet dander, dust mites, cockroach allergens, molds, and pollens. Common respiratory irritants include tobacco smoke, pollution, and fumes from burning wood or gas.

The doctor will use a stethoscope to listen to the lungs. Asthma-related sounds may be heard. However, lung sounds are usually normal between asthma episodes.

Tests may include:

Lung function tests
Peak flow measurements
Chest x-ray
Blood tests, including eosinophil count (a type of white blood cell)
Arterial blood gas

Treatment

Treatment is aimed at avoiding known allergens and respiratory irritants and controlling symptoms and airway inflammation through medication.

There are two basic kinds of medication for the treatment of asthma:

Long-term control medications are used on a regular basis to prevent attacks, not for treatment during an attack. Types include:

Inhaled steroids (such as Azmacort, Vanceril, AeroBid, Flovent) prevent inflammation
Leukotriene inhibitors (such as Singulair and Accolate)
Anti-IgE therapy (Xolair), a medicine given by injection to patients with more severe asthma
Long-acting bronchodilators (such as Serevent) help open airways
Cromolyn sodium (Intal) or nedocromil sodium
Aminophylline or theophylline (not used as frequently as in the past)

Sometimes a combination of steroids and bronchodilators are used, using either separate inhalers or a single inhaler (such as Advair Diskus).

Quick relief, or rescue, medications are used to relieve symptoms during an attack. These include:

Short-acting bronchodilators (inhalers), such as Proventil, Ventolin, Xopenex, and others.
Corticosteroids, such as prednisone or methylprednisolone) given by mouth or into a vein

Persons with mild asthma (infrequent attacks) may use quick relief medication as needed. Those with persistent asthma should take control medications on a regular basis to prevent symptoms. A severe asthma attack requires a medical evaluation and may require a hospital stay, oxygen, and intravenous medications.

A peak flow meter, a simple device to measure lung volume, can be used at home to help you "see an attack coming" and take the appropriate action, sometimes even before any symptoms appear. If you are not monitoring asthma on a regular basis, an attack can take you by surprise.

Peak flow measurements can help show when medication is needed, or other action needs to be taken. Peak flow values of 50-80% of an individual’s personal best results indicate a moderate asthma attack, while values below 50% indicate a severe attack.

Support Groups

The stress caused by illness can often be helped by joining a support group, where members share common experiences and problems.

Expectations (prognosis)

There is no cure for asthma, though symptoms sometimes decrease over time. With proper self management and medical treatment, most people with asthma can lead normal lives.

Complications

Respiratory fatigue
Side effects of asthma medications
Pneumothorax
Death

Calling your health care provider

Call for an appointment with your health care provider if you or your child experience mild asthma symptoms (to discuss treatment options).

Call your health care provider (or go to the emergency room) for moderate shortness of breath (shortness of breath with talking, peak flow 50-80% of personal best), if symptoms worsen or do not improve with treatment, or an attack requires more medication than recommended in the prescription.

Go to the emergency room for severe shortness of breath (shortness of breath at rest, peak flow less than 50% of personal best), if drowsiness or confusion develops, or for severe chest pain.

Prevention

Asthma symptoms can be substantially reduced by avoiding known allergens and respiratory irritants. If someone with asthma is sensitive to dust mites, exposure can be reduced by encasing mattresses and pillows in allergen-impermeable covers, removing carpets from bedrooms, and by vacuuming regularly. Exposure to dust mites and mold can be reduced by lowering indoor humidity.

If a person is allergic to an animal that cannot be removed from the home, the animal should be kept out of the patient's bedroom. Filtering material can be placed over the heating outlets to trap animal dander. Exposure to cigarette smoke, air pollution, industrial dusts, and irritating fumes should also be avoided.

Allergy desensitization may be helpful in reducing asthma symptoms and medication use, but the size of the benefit compared with other treatments is not known.

Diarrhea

2007-01-18T16:53:00.000-05:00

What is Diarrhea?

What is diarrhea?Diarrhea—loose, watery stools occurring more than three times in one day—is a common problem that usually lasts a day or two and goes away on its own without any special treatment. However, prolonged diarrhea can be a sign of other problems. People with diarrhea may pass more than a quart of stool a day.

Diarrhea can cause dehydration, which means the body lacks enough fluid to function properly. Dehydration is particularly dangerous in children and the elderly, and it must be treated promptly to avoid serious health problems.

People of all ages can get diarrhea. The average adult has a bout of diarrhea about four times a year.

What causes diarrhea?

Diarrhea may be caused by a temporary problem, like an infection, or a chronic problem, like an intestinal disease. A few of the more common causes of diarrhea are

Bacterial infections. Several types of bacteria, consumed through contaminated food or water, can cause diarrhea. Common culprits include Campylobacter, Salmonella, Shigella, and Escherichia coli.
Viral infections. Many viruses cause diarrhea, including rotavirus, Norwalk virus, cytomegalovirus, herpes simplex virus, and viral hepatitis.
Food intolerances. Some people are unable to digest some component of food, such as lactose, the sugar found in milk.
Parasites. Parasites can enter the body through food or water and settle in the digestive system. Parasites that cause diarrhea include Giardia lamblia, Entamoeba histolytica, and Cryptosporidium.
Reaction to medicines, such as antibiotics, blood pressure medications, and antacids containing magnesium.
Intestinal diseases, like inflammatory bowel disease or celiac disease.
Functional bowel disorders, such as irritable bowel syndrome, in which the intestines do not work normally.

Some people develop diarrhea after stomach surgery or removal of the gallbladder. The reason may be a change in how quickly food moves through the digestive system after stomach surgery or an increase in bile in the colon that can occur after gallbladder surgery.

In many cases, the cause of diarrhea cannot be found. As long as diarrhea goes away on its own, an extensive search for the cause is not usually necessary.

People who visit foreign countries are at risk for traveler's diarrhea, which is caused by eating food or drinking water contaminated with bacteria, viruses, or, sometimes, parasites. Traveler's diarrhea is a particular problem for people visiting developing countries. Visitors to the United States, Canada, most European countries, Japan, Australia, and New Zealand do not face much risk for traveler's diarrhea.

What are the symptoms?

Diarrhea may be accompanied by cramping abdominal pain, bloating, nausea, or an urgent need to use the bathroom. Depending on the cause, a person may have a fever or bloody stools.

Diarrhea can be either acute (short-term) or chronic (long-term). The acute form, which lasts less than 4 weeks, is usually related to a bacterial, viral, or parasitic infection. Chronic diarrhea lasts more than 4 weeks and is usually related to functional disorders like irritable bowel syndrome or inflammatory bowel diseases like celiac disease.

Diarrhea in Children

Children can have acute or chronic forms of diarrhea. Causes include bacteria, viruses, parasites, medications, functional disorders, and food sensitivities. Infection with the rotavirus is the most common cause of acute childhood diarrhea. Rotavirus diarrhea usually resolves in 3 to 9 days.

Medications to treat diarrhea in adults can be dangerous to children and should be given only under a doctor's guidance.

Diarrhea can be dangerous in newborns and infants. In small children, severe diarrhea lasting just a day or two can lead to dehydration. Because a child can die from dehydration within a few days, the main treatment for diarrhea in children is rehydration.

Take your child to the doctor if any of the following symptoms appear:

stools containing blood or pus, or black stools
temperature above 101.4 degrees Fahrenheit
no improvement after 24 hours
signs of dehydration (see below)

What is dehydration?

General signs of dehydration include

thirst
less frequent urination
dry skin
fatigue
light-headedness
dark colored urine

Signs of dehydration in children include

dry mouth and tongue
no tears when crying
no wet diapers for 3 hours or more
sunken abdomen, eyes, or cheeks
high fever
listlessness or irritability
skin that does not flatten when pinched and released

If you suspect that you or your child is dehydrated, call the doctor immediately. Severe dehydration may require hospitalization.

When should a doctor be consulted?

Although usually not harmful, diarrhea can become dangerous or signal a more serious problem. You should see the doctor if any of the following is true:

You have diarrhea for more than 3 days.
You have severe pain in the abdomen or rectum.
You have a fever of 102 degrees Fahrenheit or higher.
You see blood in your stool or have black, tarry stools.
You have signs of dehydration.

If your child has diarrhea, do not hesitate to call the doctor for advice. Diarrhea can be dangerous in children if too much fluid is lost and not replaced quickly.

What tests might the doctor do?

Diagnostic tests to find the cause of diarrhea include the following:

Medical history and physical examination. The doctor will need to know about your eating habits and medication use and will examine you for signs of illness.
Stool culture. Lab technicians analyze a sample of stool to check for bacteria, parasites, or other signs of disease or infection.
Blood tests. Blood tests can be helpful in ruling out certain diseases.
Fasting tests. To find out if a food intolerance or allergy is causing the diarrhea, the doctor may ask you to avoid lactose (found in milk products), carbohydrates, wheat, or other foods to see whether the diarrhea responds to a change in diet.
Sigmoidoscopy. For this test, the doctor uses a special instrument to look at the inside of the rectum and lower part of the colon.
Colonoscopy. This test is similar to sigmoidoscopy, but the doctor looks at the entire colon.

What is the treatment?

In most cases, replacing lost fluid to prevent dehydration is the only treatment necessary. Medicines that stop diarrhea may be helpful in some cases, but they are not recommended for people whose diarrhea is caused by a bacterial infection or parasite—stopping the diarrhea traps the organism in the intestines, prolonging the problem. Instead, doctors usually prescribe antibiotics. Viral causes are either treated with medication or left to run their course, depending on the severity and type of the virus.

Preventing Dehydration

Dehydration occurs when the body has lost too much fluid and electrolytes (the salts potassium and sodium). The fluid and electrolytes lost during diarrhea need to be replaced promptly—the body cannot function properly without them. Dehydration is particularly dangerous for children, who can die from it within a matter of days.

Although water is extremely important in preventing dehydration, it does not contain electrolytes. To maintain electrolyte levels, you could have broth or soups, which contain sodium, and fruit juices, soft fruits, or vegetables, which contain potassium.

For children, doctors often recommend a special rehydration solution that contains the nutrients they need. You can buy this solution in the grocery store without a prescription. Examples include Pedialyte, Ceralyte, and Infalyte.

Tips About Food

Until diarrhea subsides, try to avoid milk products and foods that are greasy, high-fiber, or very sweet. These foods tend to aggravate diarrhea.

As you improve, you can add soft, bland foods to your diet, including bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken without the skin or fat. For children, the pediatrician may recommend what is called the BRAT diet: bananas, rice, applesauce, and toast.

Preventing Traveler's Diarrhea

Traveler's diarrhea happens when you consume food or water contaminated with bacteria, viruses, or parasites. You can take the following precautions to prevent traveler's diarrhea when you go abroad:

Do not drink any tap water, not even when brushing your teeth.
Do not drink unpasteurized milk or dairy products.
Do not use ice made from tap water.
Avoid all raw fruits and vegetables (including lettuce and fruit salad) unless they can be peeled and you peel them yourself.
Do not eat raw or rare meat and fish.
Do not eat meat or shellfish that is not hot when served to you.
Do not eat food from street vendors.

You can safely drink bottled water (if you are the one to break the seal), carbonated soft drinks, and hot drinks like coffee or tea.

Depending on where you are going and how long you are staying, your doctor may recommend that you take antibiotics before leaving to protect you from possible infection.

Hope Through Research

NIDDK's Division of Digestive Diseases and Nutrition supports basic and clinical research into gastrointestinal conditions, including diarrhea. Among other areas, researchers are studying how the processes of absorption and secretion in the digestive tract affect the content and consistency of stool, the mechanisms by which E. coli infection causes diarrhea, and chemical compounds that may be useful in treating diarrhea.

Points to Remember

Diarrhea is a common problem that usually resolves on its own.
Diarrhea is dangerous if a person becomes dehydrated.
Causes include viral, bacterial, or parasitic infections; food intolerance; reactions to medicine; intestinal diseases; and functional bowel disorders.
Treatment involves replacing lost fluids and electrolytes. Depending on the cause of the problem, a person might also need medication to stop the diarrhea or treat an infection. Children may need an oral rehydration solution to replace lost fluids and electrolytes.
Call the doctor if a person with diarrhea has severe pain in the abdomen or rectum, a fever of 102 degrees Fahrenheit or higher, blood in the stool, signs of dehydration, or diarrhea for more than 3 days.

Indigestion

2007-01-18T16:45:00.000-05:00

Alternative names

Dyspepsia; Uncomfortable fullness after meals

Definition

Indigestion is a vague feeling of abdominal discomfort -- possibly including belching, a feeling of fullness, bloating, and nausea.

Considerations

Indigestion is usually not a serious health problem, unless it comes with other symptoms.

Indigestion is a common problem. It may be triggered by eating particular foods, or drinking wine or carbonated drinks. It may also be caused by eating too fast or by overeating. Some people may find that spicy foods, high-fiber foods, fatty foods, or too much caffeine can all make this problem worse. Symptoms may be worsened by anxiety and depression.

Rarely, the discomfort of a heart attack is mistaken for indigestion.

Indigestion can be a symptom of a bowel disease like nonulcer dyspepsia.

Common Causes

Overeating
Eating too fast
Having too much caffeine
Eating fatty or greasy foods
Drinking too much alcohol
Tobacco smoking
Eating spicy foods
Emotional trauma or nervousness
Cholecystitis (inflammation of the gallbladder)
Acute or chronic gastritis (inflammation of the stomach)
Acute or chronic pancreatitis (inflammation of the pancreas)
Duodenal ulcer
Gastric ulcer
Drugs such as antibiotics, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs)

Home Care

Allow time for long meals.
Chew food carefully and completely.
Avoid arguments during meals.
Avoid excitement or exercise immediately after a meal.
Avoid chewing gum -- it may cause air swallowing.
A calm environment and rest may help relieve stress-related indigestion.
Avoid aspirin and NSAIDs (use acetaminophen instead). If you must take them, do so on a full stomach.
Antacids may relieve indigestion. Stronger medications are available over-the-counter, such as ranitidine (Zantac). Your doctor may prescribe similar medications, or stronger ones such as omeprazole (Prilosec).

Call your health care provider if

Your symptoms last longer than a few days
The pattern of indigestion symptoms changes noticeably
You have sudden, severe abdominal pain
You have unexplained weight loss
You vomit blood or pass blood in the stool
You have jaundice (yellow coloring of the skin and eyes)
Symptoms include jaw pain, chest pain, back pain, profuse sweating, anxiety, or a feeling of impending doom (possible heart attack symptoms)

What to expect at your health care provider's office

Your doctor will perform a physical examination, paying special attention to the stomach area and digestive system. The doctor will ask questions related to your indigestion. For example:

Does it begin or get worse after eating particular foods?
Does it begin or get worse after drinking alcoholic or carbonated drinks?
Do you eat fast?
Have you been overeating?
Have you changed your diet? Have you had any spicy foods, high-fiber foods, or fatty foods? Have you had a lot of caffeine?
What medications are you taking?
Have you changed medications recently?
What other symptoms do you have?
Do you have stomach pain?
Are you vomiting?

The following tests may be performed:

Blood tests (depending on the suspected cause)
Endoscopy (EGD)
Upper GI and small bowel series (with barium)
Abdominal ultrasound

First- Aid Kit

2007-01-18T10:00:00.000-05:00

A first aid kit is a collection of supplies and equipment for use in giving first aid, particularly in a medical emergency. Most first aid kits contain bandages for controlling bleeding, personal protective equipment such as gloves and a breathing barrier for performing rescue breathing and CPR (cardiopulmonary resuscitation), and sometimes instructions on how to perform first aid.

Most store bought first aid kits, especially the cheap ones, are very poor in terms of quality, quantity, and selection of items, and are only suited for treating very minor injuries. A homemade kit, if properly prepared, is generally better and sometimes cheaper than most commercial kits.

A generic first aid kit is better than nothing. However, the contents of a first aid kit should be optimized for local conditions. For example, a kit for hikers in snake country should have a snakebite kit. A kit aboard a boat should have medications for seasickness.

One list of items for a first aid kit are as follows:

Dressings (sterile, applied directly to wound)

Pads

Sterile eye pads

Sterile gauze pads

Sterile nonadherent pads

Burn dressing (sterile pad soaked in a cooling gel)

Occlussive dressing (airtight dressing, can be used to treat a 'sucking chest wound', in which air is sucked into the chest cavity, collapsing the lung (pneumothorax). For this use, occlussive dressings should be taped on 3 sides only, to create a 'one-way valve')

petroleum gauze (also used as non-adherent dressing)

Half of any gauze wrapper can be used, since the inside is sterile and air-tight

Bandages (sterility is not necessary, used to secure a dressing)

Gauze Roller bandages - absorbent, breathable, and often elastic

Elastic bandages - used for sprains, and pressure bandages

Adhesive, elastic roller bandages - Very effective pressure bandages or durable, waterproof bandaging

Triangular bandages - used as slings, tourniquets, to tie splints, and many other uses

Disposable gloves should be provided in a first aid kit

Medications

Single use packets of medications, ointments, and antiseptics will prolong shelf life, decrease contamination risk, reduce risk of leakage (usually), and save space (for small quantities). If large amounts of a medication are needed, a multi-use container can be used in addition, but keep single-use packets as a backup. For general household use (not in first aid kits), single use packets can be wasteful and bad for the environment.

Antiseptics/antimicrobial

Povidone iodine wipes - very effective and painless, but messy. Can also be used to purify water

Benzalkonium Chloride - painless, effective, often includes anesthetic. (Bactine is one brand.)

Alcohol pads - should not be used on open cuts or wounds, since they cause tissue damage and delay healing. They can be used to prep unbroken skin for injections etc. or to disinfect equipment such as thermometers. While not a medical use, alcohol pads are also useful as a solvent to remove ink, adhesives, etc.

Antibiotic ointment - single, double, or triple antibiotic ointment in petroleum jelly base (i.e. Neosporin, Polysporin). Since it has a petroleum jelly base, it can be used for things such as chapped lips.

Antiseptic/anesthetic ointment or spray

Anti-itch ointment (especially for outdoor kits)

Hydrocortisone cream

Antihistamine cream, such as benadryl

Calamine lotion

Painkillers / fever reducers (since moderate fevers are beneficial, avoid unless necessary)

Acetaminophen (brand name Tylenol)

Ibuprofen (such as Advil) - anti-inflammatory, often more effective that acetaminophen

Naproxen (such as Aleve) - similar to ibuprofen, but stronger and longer lasting

Aspirin - one 300mg Aspirin tablet may be given to a patient suffering a heart attack, to be chewed slowly.

Antihistamines - can treat allergies and allergic reactions, including life-threatening anaphylactic shock. Although OTC (over-the-counter) medications are far less effective at treating anaphylaxis than epinephrine or prescription drugs, they are much better than nothing and can be potentially life saving, and therefore may be the most valuable medication in a first aid kit.

Diphenhydramine (brand name Benadryl)

Aloe vera gel - used for a wide variety of skin problems, including burns, sunburns, itching, and dry skin

Burn gel - a water based gel that acts as a cooling agent and often includes a mild anesthetic such as lidocaine and, sometimes, an antiseptic such as Tea Tree Oil (Melaleuca Oil)

Epinephrine auto-injector (brand name Epipen) - Often included in kits for wilderness use and in places like summer camps, to treat anaphylactic shock. Requires a prescription and can be used with minimal training.

Poison treatments

Activated charcoal - to be used when directed by poison control.

Syrup of ipecac - to be used when directed by poison control.

QuikClot is a hemostatic agent sometimes included in first aid kits, especially military kits, to control severe bleeding. It is recent product not yet widely marketed to civilians, although in 2002 Z-Medica (maker of QuikClot) received FDA clearance to do so.

Sinusitis

2007-01-17T17:45:00.000-05:00

What are Sinuses?

The air chambers in the bone behind your cheeks, eyebrows and jaw are called sinuses. They make mucus, a fluid that cleans bacteria and other particles out of the air you breathe. Tiny hairs called cilia (say: “sill-ee-ah”) sweep mucus out of your sinuses so it can drain out through your nose.

What is sinusitis?

Sinusitis (say: “sine-you-site-iss”) is the name for a condition in which the lining of your sinuses becomes inflamed.

What causes sinusitis?

Anything that causes swelling in your sinuses or keeps the cilia from moving mucus can cause sinusitis. This can occur because of changes in temperature or air pressure. Using decongestant nasal sprays too much, smoking, and swimming or diving can also increase your risk of getting sinusitis. Some people have growths called polyps (say: “pawl-ips”) that block their sinus passages.

When sinusitis is caused by a bacterial or viral infection, you get a sinus infection. Sinus infections sometimes occurs after you’ve had a cold. The cold virus attacks the lining of your sinuses, causing them to swell and become narrow. Your body responds to the virus by producing more mucus, but it gets blocked in your swollen sinuses. This built-up mucus makes a good place for bacteria to grow. The bacteria can cause a sinus infection.

What are the signs of acute sinusitis?

A cold that starts to get better and then gets worse may be a sign of acute sinusitis. Pain or pressure in some areas of the face (forehead, cheeks or between the eyes) is often a sign of blocked sinus drainage and can be a sign of acute sinusitis. Pain in your forehead that starts when you lean forward can also be a sign. Other symptoms may include a stuffy nose, fever and an ache in your upper teeth.

How is acute sinusitis treated?

Your doctor may prescribe an antibiotic (medicine that kills bacteria). You may take an antibiotic for 10 to 14 days, but you will usually start feeling better a couple of days after you start taking it. It is important to take this medicine exactly as your doctor tells you and to continue taking it until it is gone, even after you’re feeling better. If you have sinus pain or pressure, your doctor may prescribe or recommend a decongestant to help your sinuses drain.

Tips on taking care of sinusitis

Get plenty of rest. Lying down can make your sinuses feel more stopped-up, so try lying on the side that lets you breathe the best.
Sip hot liquids and drink plenty of fluids.
Apply moist heat by holding a warm, wet towel against your face or breathing in steam through a cloth or towel.
Talk with your doctor before using an over-the-counter cold medicine. Some cold medicines can make your symptoms worse or cause other problems.
Don’t use a nose spray with a decongestant in it for more than 3 days. If you use it for more than 3 days, the swelling in your sinuses may get worse when you stop the medicine.
Use an over-the-counter medicine such as acetaminophen (one brand name: Tylenol) for pain.
Rinse your sinus passages with a saline solution. You can buy an over-the-counter saline solution or ask your doctor how to make one at home

The Common Cold

2007-01-17T17:37:00.000-05:00

The Common Cold

From the sniffles and sneezes to a sore throat and annoying cough, the common cold usually catches up with us at one time or another. With kids getting as many as eight colds per year or more, this contagious viral infection of the upper respiratory tract is the most common infectious disease in the United States and the number-one reason children visit the doctor and stay home from school.

Causes

Most colds are caused by rhinoviruses (the name comes from "rhin," the Greek word for nose) that are in invisible droplets in the air we breathe or on things we touch. More than 100 different rhinoviruses can infiltrate the protective lining of the nose and throat, triggering an immune system reaction that can make your child's throat sore, his or her head ache, and can make it hard for your child to breathe through the nose.

Air that's dry - indoors or out - can lower your child's resistance to infection by the viruses that cause colds. And so can being a smoker or being around someone who's smoking. People who smoke are more likely to catch a cold than people who don't - and their symptoms will probably be worse, last longer, and are more likely to lead to bronchitis or even pneumonia.

But despite what old wives' tales may have you believe, not wearing a jacket or sweater when it's chilly, sitting or sleeping in a draft, and going outside while your hair's wet do not cause colds.

Signs and Symptoms

The first symptoms of a cold are often a tickle in the throat, a runny or stuffy nose, and sneezing. Kids with colds may also have a sore throat, cough, headache, mild fever, fatigue, muscle aches, and loss of appetite. The discharge from your child's nose may change from watery to thick yellow or green.

Contagiousness

Colds are most contagious during the first 2 to 4 days after symptoms appear, and may be contagious for up to 3 weeks. Your can catch a cold from person-to-person contact or by breathing in virus particles that are spread through the air by sneezing or coughing. Touching the mouth or nose after touching skin or another surface contaminated with a rhinovirus can also spread a cold.

Prevention

Because so many viruses cause them, there isn't a vaccine that can protect against catching colds. But to help prevent them, kids should:

try to steer clear of anyone who smokes or who has a cold. Virus particles can travel up to 12 feet (3.7 meters) through the air when someone with a cold coughs or sneezes, and even secondhand smoke can make your child more likely to get sick.
wash their hands thoroughly and frequently, especially after blowing their noses.
cover their noses and mouths when coughing or sneezing.
not use the same towels or eating utensils as someone who has a cold. They also shouldn't drink from the same glass, can, or bottle as anyone else - you never know who might be about to come down with a cold and is already spreading the virus.
not pick up other people's used tissues

Researchers aren't sure whether taking extra zinc or vitamin C can limit how long cold symptoms last or how severe they become, but large doses taken every day can cause negative side effects. The results of most studies on the value of herbal remedies, such as echinacea, are either negative or inconclusive, and few properly designed scientific studies of these treatments have been done in children. Talk to your child's doctor before you decide to give your child any herbal remedy or more than the recommended daily allowance (RDA) of any vitamin or supplement.

Duration

Cold symptoms usually appear 2 or 3 days after exposure to a source of infection. Most colds clear up within 1 week, but some last for as long as 2 weeks.

Treatment

"Time cures all." That may not always be true, but in the case of the common cold, it's pretty close. Medicine can't cure the common cold, but it can be used to relieve such symptoms as muscle aches, headache, and fever. You can give your child acetaminophen or ibuprofen based on the package recommendations for age or weight.

However, aspirin should never be given to children younger than 12, and all children and teens under age 19 should avoid aspirin during viral illnesses. Use of aspirin by kids or teens with colds or other viral illness may increase the risk of developing Reye syndrome, a rare but serious condition that can be fatal.

Although you may be tempted to give your child over-the-counter (OTC) decongestants and antihistamines to try to ease the cold symptoms, there's little or no evidence to support that they actually work. In fact, decongestants can cause hallucinations, irritability, and irregular heartbeats in infants and shouldn't be used in children younger than 2 without first consulting a doctor.

Some ways you can help ease cold discomfort include:

saltwater drops in the nostrils to relieve nasal congestion (you can buy these - also called saline nose drops - at any pharmacy)
a cool-mist humidifier to increase air moisture
petroleum jelly on the skin under the nose to soothe rawness
hard candy or cough drops to relieve sore throat (for kids older than 3 years)
a warm bath or heating pad to soothe aches and pains
steam from a hot shower to help your child breathe more easily

But what about chicken soup? There's no real proof that eating this soothing, warm concoction can cure a cold, but sick people have been swearing by it for more than 800 years. Why? Chicken soup contains a mucus-thinning amino acid called cysteine, and some research shows that chicken soup helps control congestion-causing white cells, called neutrophils.

The best plan, though, is not to worry about whether to "feed a cold" or "starve a fever." Just make sure your child eats when hungry and drinks plenty of fluids like water or juice to help replace the fluids lost during fever or mucus production. Avoid giving your child caffeinated beverages, though, which can cause frequent urination and, therefore, increase the risk of dehydration.

When to Call Your Child's Doctor

Your child's doctor won't be able to identify which specific virus is causing your child's cold symptoms, but can examine your child's throat and ears and take a throat culture to make sure the symptoms aren't from another condition that may need specific treatment. (If your child's symptoms get worse instead of better after 3 days or so, the problem could be strep throat, sinusitis, pneumonia, or bronchitis, especially if your child or teen smokes.) Taking a throat culture is a simple, painless procedure that involves brushing the inside of the throat with a long cotton swab. Examining the germs that stick to the swab will help the doctor determine whether your child has strep throat and needs treatment with antibiotics.

If symptoms last for more than a week, appear at the same time every year, or occur when your child is exposed to pollen, dust, animals, or another substance, your child could have an allergy. If your child has trouble breathing or wheezes when he or she catches a cold, your child could have asthma.

You should also see your child's doctor if you think your child might have more than a cold, or if he or she is getting worse instead of getting better.

Also call the doctor if your child has any of these symptoms:

coughing up a lot of mucus
shortness of breath
unusual lethargy/tiredness
inability to keep food or liquids down or poor fluid intake
increasing headache or facial or throat pain
severely painful sore throat that interferes with swallowing
fever of 103 degrees Fahrenheit (39.3 degrees Celsius) or higher, or a fever of 101 degrees Fahrenheit (38.0 degrees Celsius) or higher that lasts for more than a day
chest or stomach pain
swollen glands (lymph nodes) in the neck
earache

Like most virus infections, colds just have to run their course. Getting plenty of rest, avoiding vigorous activity, and drinking lots of fluids - juice, water, and noncaffeinated beverages - all may help your child feel better while on the mend.

Keeping up regular activities like going to school probably won't make your child's cold any worse. But it will increase the likelihood that the cold will spread to classmates or friends. So you might want to put some daily routines aside until your child is feeling better.

Heart-Burn (GERD)

2007-01-17T17:31:00.000-05:00

What is Heart Burn?

Heart burn is a discomfort or pain caused by the stomach contents traveling up from the stomach up into the gullet (lower part of your esophagus). The gullet is not made to withstand acid and is irritated and inflamed when acid from the stomach travels up into it.

Sometimes the pain caused by heart burn can also be felt in the mid-line of the back.

Heartburn has nothing to do with the heart. Heart burn is a digestive problem. Heart burn is usually related to meals and posture and can often be relieved by remedies for indigestion. Most people suffer from heart burn at one time or another during their lifetime.

If you have heartburn, you might have a bitter taste in your mouth from stomach acid.

Heart burn is also called Gastro Esophageal Reflux Disease (GERD)

What are the Symptoms of Heart Burn?

The main symptoms are: burning sensation in the center of the chest and belching.

What Causes Heart Burn?

Heart burn is caused by a faulty muscle in the stomach. There is a "flap" at the top of the stomach that stops food from traveling back up into the esophagus. Sometimes the flap doesn't work properly and stomach acid escapes from the stomach. When the acid escapes, heartburn occurs.

Factors that contribute to Heart burn: pregnancy, smoking, eating large meals, being overweight, and wearing tight clothing around the waist.

Is Heart Burn Caused by Hiatal Hernia?

Hiatal hernia is a very common condition. It occurs when the stomach partially sits in the chest cavity through a weakness in the diaphragm. Sometimes, a persistent hiatal hernia can cause heartburn. However, many people who experience heartburn do not have a hiatal hernia. Also, many people with a hiatal hernia do not experience heartburn. Your doctor can determine if heartburn is caused by a hiatal hernia.

Heart Burn Statistics

In the United States, about 50% of the population has heart burn at least once a month. About 7% of the population has heart burn daily.

How is Heart Burn Treated?

Heart burn can be treated by antacids or medication provided by your doctor.Usual medications include Proton Pump Inhibitors(PPI's).

Complications of Heart Burn

If heart burn is not controlled, it can cause serious complications. Some common complications of heart burn are:

Esophagitis
Esophageal bleeding
Esophageal ulcer
Barrett's esophagus
Strictures
Increased risk of esophageal cancer